Individual
MR. ALEXANDER JASON WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
133 E MERRICK RD, VALLEY STREAM, NY 11580-5900
(516) 887-5500
(516) 887-5509
Mailing address
24 CARRIAGE RD, ROSLYN, NY 11576-3118
(516) 741-2998
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/20/2011
Last updated
08/20/2020
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