Healthcare Provider Details

I. General information

NPI: 1023256559
Provider Name (Legal Business Name): GABRIELA WOJNARSKA-ALVAREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W GRAND AVE SUITE 105
MONTVALE NJ
07645-1729
US

IV. Provider business mailing address

145 NORTH AVE
PARK RIDGE NJ
07656-1610
US

V. Phone/Fax

Practice location:
  • Phone: 101-746-9333
  • Fax: 201-746-9335
Mailing address:
  • Phone: 201-893-5811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number25MA08598900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: