Individual
ALICIA TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 LOFT RD, SMITHTOWN, NY 11787-4115
(631) 697-4687
Mailing address
15 LOFT RD, SMITHTOWN, NY 11787-4115
(631) 697-4687
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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