Provider Demographics
NPI:1932125465
Name:ALMENDRAL, ALICIA STA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:STA MARIA
Last Name:ALMENDRAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 MICKLE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6311
Mailing Address - Country:US
Mailing Address - Phone:718-652-0474
Mailing Address - Fax:
Practice Address - Street 1:2347 MICKLE AVE FL 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-6311
Practice Address - Country:US
Practice Address - Phone:917-633-7710
Practice Address - Fax:888-720-6963
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236741207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02799219Medicaid
NY5803C1Medicare UPIN