Healthcare Provider Details

I. General information

NPI: 1033435631
Provider Name (Legal Business Name): ALICIA MARIE POINTER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MANCHESTER RD STE 105
POUGHKEEPSIE NY
12603-2587
US

IV. Provider business mailing address

301 MANCHESTER RD STE 105
POUGHKEEPSIE NY
12603-2587
US

V. Phone/Fax

Practice location:
  • Phone: 845-452-1700
  • Fax: 845-452-1752
Mailing address:
  • Phone: 845-452-1700
  • Fax: 845-452-1752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number257148
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number279208
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier04156281
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: