Individual
ALICIA D BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
455 BOSTON POST RD STE 10, OLD SAYBROOK, CT 06475-1554
(860) 388-9799
(860) 388-6626
Mailing address
455 BOSTON POST RD STE 10, OLD SAYBROOK, CT 06475-1554
(860) 388-9799
(860) 388-6626
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA00662
RI
363AM0700X
Medical Physician Assistant
Primary
002637
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002637
LICENSE
CT
01
—
2367
LICENSE
CT
01
—
PA00662
LICENSE
RI
Enumeration date
10/11/2011
Last updated
03/04/2016
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