Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Charles J Licata, DO

Individual provider Internal Medicine Physician · NPI 1538172523

Dr. Charles J Licata, DO is an Internal Medicine Physician in Bristol, Connecticut. Licensed in Connecticut. Registered with an NPI since 2006.

Licensed in
CT
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

625 Clark Ave
Bristol, CT 06010-4068
Phone: (860) 583-7700
Fax: (860) 589-7656
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 000359 (CT)

Record details

NPI number1538172523
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedAugust 14, 2006
Last updated in NPPESJuly 8, 2007
Mailing address4 Farm Springs Rd, Prohealth Physicians, Farmington, CT 06032-2573

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