Individual
LUIS ALICEA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2869 BAINBRIDGE AVE APT 2C, BRONX, NY 10458-2830
(718) 584-8633
Mailing address
2869 BAINBRIDGE AVE APT 2C, BRONX, NY 10458-2830
(718) 584-8633
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000018995
NY
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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