Individual
MRS. TANIA NATICHA ALICEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
101 NICOLLS RD, HSC 9, RM 020, STONY BROOK, NY 11794-0001
(631) 444-3987
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 578-3178
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
F001951
NY
Other
Enumeration date
08/28/2012
Last updated
03/03/2020
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