MEDICARE: DR. PHILLIP ALVAREZ DNP

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	363LF0000X	Family Nurse Practitioner	12.014365	CT
2	363LF0000X	Family Nurse Practitioner	355170	NY

General Provider Information

NPI Number	:	1417784778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILLIP ALVAREZ DNP

Provider Business Mailing Address
First Line	:	1400 PELHAM PKWY S
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1197
Country	:	US
Telephone Number	:	718-918-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 PELHAM PKWY S
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1138
Country	:	US
Telephone Number	:	718-519-5000
Fax Number	:

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

Provider Enumeration Date	:	09/19/2024
Last Update Date	:	05/11/2026

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