Provider Demographics
NPI:1437150638
Name:SKINNER, ALICIA J (RPA-C)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:J
Last Name:SKINNER
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:FIORI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:20 PROSPECT ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-1367
Mailing Address - Country:US
Mailing Address - Phone:518-885-3755
Mailing Address - Fax:518-885-4613
Practice Address - Street 1:20 PROSPECT ST
Practice Address - Street 2:SUITE 106
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-1367
Practice Address - Country:US
Practice Address - Phone:518-885-3755
Practice Address - Fax:518-885-4613
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010678363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPENDINGMedicare UPIN
NYPA1619Medicare PIN
NYPA2536Medicare PIN