Healthcare Provider Details

I. General information

NPI: 1629435250
Provider Name (Legal Business Name): ALICIA LASCALA LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA ARTHUR LPN

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 STATE ST
SCHENECTADY NY
12307-1511
US

IV. Provider business mailing address

1 CONWAY CT
TROY NY
12180-2108
US

V. Phone/Fax

Practice location:
  • Phone: 518-243-3300
  • Fax: 518-377-9151
Mailing address:
  • Phone: 518-274-6525
  • Fax: 518-274-6511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number213354
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: