Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Alicia Anderson

Individual provider Physician Assistant · NPI 1104584622

Alicia Anderson is a Physician Assistant in Ronkonkoma, New York. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

650 Hawkins Ave Ste 7
Ronkonkoma, NY 11779-2366
Phone: (631) 737-0055
Fax: (631) 737-0076
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1104584622
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 1, 2021
Last updated in NPPESFebruary 11, 2022
Certification dateFebruary 11, 2022
Mailing address650 Hawkins Ave Ste 7, Ronkonkoma, NY 11779-2366

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