Healthcare Provider Details

I. General information

NPI: 1861594798
Provider Name (Legal Business Name): JOHN-PATRICK B. ALVAREZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHN B ALVAREZ PA-C

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 05/05/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CAMPUS TOWN CIR STE 100
EWING NJ
08638-1962
US

IV. Provider business mailing address

90 MATAWAN RD STE 302
MATAWAN NJ
07747-2653
US

V. Phone/Fax

Practice location:
  • Phone: 609-799-7009
  • Fax: 609-799-7808
Mailing address:
  • Phone: 732-441-7177
  • Fax: 732-441-7165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00171100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: