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Provider Information for 1417578733

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. ALYCIA PAIGE HEINER DO

Other Name:   ALYCIA LEE
Gender: FEMALE

Individual NPI: 1417578733

Calendar   Last Updated:  2020-07-08
  Certification Date:  2020-07-08

Details

Name Value
NPI 1417578733
Enumeration Date 2020-04-27
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 501 S WASHINGTON AVE
SCRANTON, PA 18505-3814
United States

Phone: 570-343-2383 | Fax:
View Map External Link
Primary Practice Address PARKSIDE HEALTH CENTER 765 KENILWORTH TERRACE NE
WASHINGTON, DC 20019
United States

Phone: 202-388-8183 | Fax: 202-548-8600
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 390200000X - Student in an Organized Health Care Education/Training Program