1669746111 NPI number — MISS ALICIA SUZANNE MARCH SLP

Table of content: MISS ALICIA SUZANNE MARCH SLP (NPI 1669746111)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669746111 NPI number — MISS ALICIA SUZANNE MARCH SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARCH
Provider First Name:
ALICIA
Provider Middle Name:
SUZANNE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669746111
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
179 COUNTY ROUTE 64
Provider Second Line Business Mailing Address:
OSWEGO COUNTY BOCES
Provider Business Mailing Address City Name:
MEXICO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13114-4219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-963-4315
Provider Business Mailing Address Fax Number:
315-963-4391

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
179 COUNTY ROUTE 64
Provider Second Line Business Practice Location Address:
OSWEGO COUNTY BOCES
Provider Business Practice Location Address City Name:
MEXICO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13114-4219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-963-4315
Provider Business Practice Location Address Fax Number:
315-963-4391
Provider Enumeration Date:
03/01/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  010538-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)