Provider Demographics
NPI:1508268632
Name:GETZKE, ALYCIA NICOLE
Entity Type:Individual
Prefix:
First Name:ALYCIA
Middle Name:NICOLE
Last Name:GETZKE
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 1:526 CAFFERTY HILL RD
Mailing Address - Street 2:
Mailing Address - City:ENDICOTT
Mailing Address - State:NY
Mailing Address - Zip Code:13760-8910
Mailing Address - Country:US
Mailing Address - Phone:607-232-2350
Mailing Address - Fax:
Practice Address - Street 1:526 CAFFERTY HILL RD
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-8910
Practice Address - Country:US
Practice Address - Phone:607-232-2350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY631727163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse