Provider Demographics
NPI:1750376372
Name:BAIR, ALICIA K (MD)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:K
Last Name:BAIR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:750 E ADAMS ST
Mailing Address - Street 2:REGIONAL ONCOLOGY CENTER
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2342
Mailing Address - Country:US
Mailing Address - Phone:315-464-8200
Mailing Address - Fax:315-464-8206
Practice Address - Street 1:21 N 2ND ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1250
Practice Address - Country:US
Practice Address - Phone:315-598-7105
Practice Address - Fax:315-598-4857
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2022-11-09
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Provider Licenses
StateLicense IDTaxonomies
NY2206881207RH0003X
NY220688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02565644Medicaid
NY02565644Medicaid
NYP00903658Medicare PIN