Provider Demographics
NPI:1619478492
Name:ALICEA, VERONICA
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:
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 1:120 ALCOTT PLACE
Mailing Address - Street 2:20 D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4220
Mailing Address - Country:US
Mailing Address - Phone:917-361-2380
Mailing Address - Fax:
Practice Address - Street 1:120 ALCOTT PL APT 20D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4220
Practice Address - Country:US
Practice Address - Phone:191-736-1238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY459472163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse