Basic Information
| Provider Information | |||||||||
| NPI: | 1740386168 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALECCIA | ||||||||
| FirstName: | DORENE | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | F.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 276-280 ROBINSON ST | ||||||||
| Address2: | |||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139041659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077717234 | ||||||||
| FaxNumber: | 6077722095 | ||||||||
| Practice Location | |||||||||
| Address1: | 276-280 ROBINSON ST | ||||||||
| Address2: | |||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139041659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077717234 | ||||||||
| FaxNumber: | 6077722095 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 332724 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.