| Doctor Name: | ANTHONY M LOCICERO |
| NPI Number: | 1023047610 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 005180 |
| Business Practice Address: | 5 Land Re Way Suite 100 Spencerport, NY - 14559 |
| Business Phone Number: | 5853686620 |
| Business Fax Number: | 5853686621 |
| Mailing Address: | 5 Land Re Way, Suite 100 SPENCERPORT |
| State: | NY |
| Postal Code: | 14559 |
| Phone Number: | 5853686620 |
| Fax Number: | 5853686621 |
| NPI Enumeration Date: | 07/03/2006 |
| NPI Last Update Date: | 02/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 005180 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |