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Individual

MRS. ALICIA SUE ROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
21 CHERRY HILL RD, STAR LAKE, NY 13690-3145
(315) 405-2871
Mailing address
21 CHERRY HILL RD, STAR LAKE, NY 13690-3145
(315) 405-2871

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
613333121
NY

Other

Enumeration date
12/07/2015
Last updated
12/07/2015
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