Provider Demographics
NPI:1689944027
Name:SIENKIEWYCZ, ALICIA LORRAINE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:LORRAINE
Last Name:SIENKIEWYCZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SUNY POTSDAM STUDENT HEALTH SERVICES
Mailing Address - Street 2:44 PIERREPONT AVENUE
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676
Mailing Address - Country:US
Mailing Address - Phone:315-267-2377
Mailing Address - Fax:315-267-3260
Practice Address - Street 1:SUNY POTSDAM STUDENT HEALTH SERVICES
Practice Address - Street 2:44 PIERREPONT AVENUE
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676
Practice Address - Country:US
Practice Address - Phone:315-267-2377
Practice Address - Fax:315-267-3260
Is Sole Proprietor?:No
Enumeration Date:2012-01-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336799-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03573448Medicaid
NYJ400175806Medicare PIN