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NPI Code Detail

MEDICARE: JAMIE ALEXANDER PICA ACNPC-AG

MEDICARE: JAMIE ALEXANDER PICA ACNPC-AG
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
1103TS0200XSchool Psychologist1162302NY
2363L00000XNurse Practitioner431523NY
3363LC0200XCritical Care Medicine Nurse Practitioner431523NY

General Provider Information

NPI Number : 1902131253
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE ALEXANDER PICA ACNPC-AG
Provider Business Mailing Address
First Line : 10 DUNMOW CRES
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-3810
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 350 PARRISH ST
Second Line :
City : CANANDAIGUA
State : NY
Zip : 14424-1793
Country : US
Telephone Number : 585-396-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2009
Last Update Date : 06/30/2023

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