Provider Demographics
NPI:1528642246
Name:NANCY ALICEA MD,PSC
Entity type:Organization
Organization Name:NANCY ALICEA MD,PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALICEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-274-0527
Mailing Address - Street 1:400 AVE FRANKLIN D ROOSEVELT
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2103
Mailing Address - Country:US
Mailing Address - Phone:787-274-0527
Mailing Address - Fax:787-764-7963
Practice Address - Street 1:400 AVE FRANKLIN D ROOSEVELT
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-274-0527
Practice Address - Fax:787-764-7963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty