Provider Demographics
NPI:1598045726
Name:BITTNER, ALICIA K (PA-C)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:K
Last Name:BITTNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:CAPPARELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1555 LONG POND RD
Mailing Address - Street 2:DEPARTMENT OF OB/GYN
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4122
Mailing Address - Country:US
Mailing Address - Phone:585-368-4006
Mailing Address - Fax:585-368-4009
Practice Address - Street 1:1555 LONG POND RD
Practice Address - Street 2:DEPARTMENT OF OB/GYN
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4122
Practice Address - Country:US
Practice Address - Phone:585-368-4006
Practice Address - Fax:585-368-4009
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015027363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400182955/GRPBA0017Medicare PIN
NYJ400182956/GRP70008AMedicare PIN