MEDICARE: MISS JULIETH ANDREA ALVAREZ JIMENEZ PA-C

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
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1033771902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JULIETH ANDREA ALVAREZ JIMENEZ PA-C

Provider Business Mailing Address
First Line	:	486 W WILLIAM ST APT 2
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-3557
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PELHAM PKWY S STE 1213
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1197
Country	:	US
Telephone Number	:	718-918-5590
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2019
Last Update Date	:	09/10/2024

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