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General NPI Number Information
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NPI Number | 1124331368
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Entity Type | Individual
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Provider Name | ALICIA JEAN ANDRIA L.AC., MT, RN
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Gender | Female
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 700 HORSEBLOCK RD
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City | FARMINGVILLE
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State | NY
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Zip | 11738
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Country | US
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Telephone | 631-732-1386
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Fax |
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Provider Business Mailing Address
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Address Line | 700 HORSEBLOCK RD
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City | FARMINGVILLE
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State | NY
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Zip | 11738-1240
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Country | US
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Telephone | 631-478-7952
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | N01797
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 025687
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 004227
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License Number State | NY
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