Provider Demographics
NPI:1629421821
Name:ELWOOD, ALICIA (FNP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:ELWOOD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 BURRSTONE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1001
Mailing Address - Country:US
Mailing Address - Phone:315-798-1561
Mailing Address - Fax:315-798-1556
Practice Address - Street 1:1 OXFORD RD STE 200
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2651
Practice Address - Country:US
Practice Address - Phone:315-738-1820
Practice Address - Fax:315-738-7908
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily