Provider Demographics
NPI:1053568675
Name:HEALY, ALICIA (LPN)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:HEALY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 LENOX RD
Mailing Address - Street 2:APT 3J
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5229
Mailing Address - Country:US
Mailing Address - Phone:516-594-5710
Mailing Address - Fax:
Practice Address - Street 1:88 LENOX RD
Practice Address - Street 2:APT 3J
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5229
Practice Address - Country:US
Practice Address - Phone:516-594-5710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228368164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse