Provider Demographics
NPI:1740285097
Name:ZALKA, ALICIA D (MD)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:D
Last Name:ZALKA
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 1:56 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-2948
Mailing Address - Country:US
Mailing Address - Phone:845-485-5000
Mailing Address - Fax:
Practice Address - Street 1:200 WESTAGE BUSINESS CTR DR STE 228
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2268
Practice Address - Country:US
Practice Address - Phone:845-485-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034517207N00000X
NY190994-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001345174Medicaid
CT001345174Medicaid
CTG03079Medicare UPIN