Provider Demographics
NPI:1710368634
Name:ASKEW, ALYCIA (LAC)
Entity Type:Individual
Prefix:MISS
First Name:ALYCIA
Middle Name:
Last Name:ASKEW
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:483 BLACK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:12865-3805
Mailing Address - Country:US
Mailing Address - Phone:518-321-4160
Mailing Address - Fax:518-633-1794
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834
Practice Address - Country:US
Practice Address - Phone:518-232-1759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005366171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist