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General NPI Number Information
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NPI Number | 1962825257
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Entity Type | Individual
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Provider Name | ALICIA MCINERNEY NP
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Gender | Female
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Dates
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Enumeration Date | 01/23/2014
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 250 TOWNSHIP BLVD STE 10
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City | CAMILLUS
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State | NY
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Zip | 13031-1674
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Country | US
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Telephone | 315-928-7060
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Fax | 315-928-7060
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Provider Business Mailing Address
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Address Line | 250 TOWNSHIP BLVD STE 10
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City | CAMILLUS
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State | NY
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Zip | 13031-1674
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Country | US
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Telephone | 315-928-7060
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Fax | 315-928-7077
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F338329-1
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License Number State | NY
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