MEDICARE: MS. ALECIA DEKOTE DUCKWORTH RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	831803	NY

General Provider Information

NPI Number	:	1265234363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALECIA DEKOTE DUCKWORTH RN

Provider Business Mailing Address
First Line	:	622 3RD AVE FL 39
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6797
Country	:	US
Telephone Number	:	347-353-2640
Fax Number	:

Provider Business Practice Location Address
First Line	:	622 3RD AVE FL 39
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-6797
Country	:	US
Telephone Number	:	212-916-0845
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2025
Last Update Date	:	03/27/2025

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