Individual
ALICIA DANTZLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
929 YORK ST, UTICA, NY 13502-3929
(315) 368-6746
Mailing address
18 FAIRFAX PL, UTICA, NY 13502-5808
(315) 368-6746
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
737091-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156002667
—
NY
Enumeration date
05/03/2022
Last updated
05/03/2022
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