Provider Demographics
NPI:1992137749
Name:ECTOR, ALICIA NICOLE
Entity type:Individual
Prefix:MISS
First Name:ALICIA
Middle Name:NICOLE
Last Name:ECTOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 E CHESTER ST
Mailing Address - Street 2:APT.D2
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3100
Mailing Address - Country:US
Mailing Address - Phone:845-399-9126
Mailing Address - Fax:
Practice Address - Street 1:284 E CHESTER ST
Practice Address - Street 2:APT.D2
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3100
Practice Address - Country:US
Practice Address - Phone:845-399-9126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-04
Last Update Date:2013-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305412-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse