Justin Alfredo Alicea, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Wilmington, DE
NPI 1730874355 · NPPES record last updated Apr 10, 2023
Key facts
- NPI
- 1730874355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 1600 Rockland Rd Ste 3D16
Wilmington, DE 19803-3607 - Phone
- (302) 651-5874
- Fax
- (302) 651-5954
- NPI assigned
- Apr 10, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230708000037 | PA | Order and Referring Only - Pediatric Medicine |
9830558881 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
1600 Rockland Rd Ste 3D16
Wilmington, DE 19803-3607
Mailing address
29 Stonehenge CT
Jackson, NJ 08527-5441
Phone (732) 796-3916
Other providers in Wilmington, DE
- Bertine Alfreide
- Sarah Ali K Alghanim
- Tabassum Ali
- Aaron Paul Alicea
- Chresencia Deidra Alicea
- Align My Spine
- Aligned Counseling LLC
- Lida Alimorad
- Anthony R Alioto
- Reem Ali Alkaabi
All providers in Wilmington, DE · Student in an Organized Health Care Education/Training Program in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.