Provider Demographics
NPI:1083930945
Name:ALICIA ALMENDRAL MD PLLC
Entity Type:Organization
Organization Name:ALICIA ALMENDRAL MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:STA MARIA
Authorized Official - Last Name:ALMENDRAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-527-2257
Mailing Address - Street 1:2347 MICKLE AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6311
Mailing Address - Country:US
Mailing Address - Phone:917-633-7710
Mailing Address - Fax:888-720-6963
Practice Address - Street 1:2347 MICKLE AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-6311
Practice Address - Country:US
Practice Address - Phone:646-220-5798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02799219Medicaid