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

Kimberly Ann Licciardi, MD

Individual provider Surgery Physician · NPI 1104976885

Kimberly Ann Licciardi, MD is an Ophthalmology in Manchester, New Hampshire. Graduated from State University of New York at Buffalo School of Medicine in 2006, 20 years ago. Practices with Elliot Professional Services, a 424-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Hampshire and Pennsylvania.

Years since qualifying
20
Trained at
State University of New York at Buffalo School of Medicine
Licensed in
NH, PA
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

764 2nd St
Manchester, NH 03102-5210
Phone: (603) 669-3925
Show map & directions

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

Additional practice locations (1)

  • 25 Buttrick Rd Ste C3, Londonderry, NH 03053-3353 — (603) 432-8801

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence 14856 (NH)
Surgery Physician Taxonomy 208600000X · Licence MT188086 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104976885
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 12, 2007
Last updated in NPPESJuly 8, 2024
Certification dateJuly 8, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPHTHALMOLOGY
Medical schoolSTATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Graduated 2006 (20 years in practice)
Group practice Elliot Professional Services — 424 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Manchester