Provider Demographics
NPI:1326297268
Name:ALICEA, JULIA M
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:M
Last Name:ALICEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 VAN WYCK EXPRESSWAY
Mailing Address - Street 2:JAMAICA HOSPITAL MEDICAL CENTER
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11418
Mailing Address - Country:US
Mailing Address - Phone:718-291-3277
Mailing Address - Fax:
Practice Address - Street 1:89 VAN WYCK EXPRESSWAY
Practice Address - Street 2:JAMAICA HOSPITAL MEDICAL CENTER
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418
Practice Address - Country:US
Practice Address - Phone:718-291-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY360335163W00000X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163W00000XNursing Service ProvidersRegistered Nurse