Provider Demographics
NPI:1336745926
Name:NICOSIA, ALICIA (CD-L)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:NICOSIA
Suffix:
Gender:F
Credentials:CD-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LAURELTON AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2435
Mailing Address - Country:US
Mailing Address - Phone:732-330-5775
Mailing Address - Fax:
Practice Address - Street 1:21 LAURELTON AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2435
Practice Address - Country:US
Practice Address - Phone:732-330-5775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula