Healthcare Provider Details
I. General information
NPI: 1629335484
Provider Name (Legal Business Name): CHRISTEN MARIE ALVES APN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/18/2012
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 NEW PROVIDENCE ROAD
MOUNTAINSIDE NJ
07092
US
IV. Provider business mailing address
182 LYONS AVENUE
NEWARK NJ
07112
US
V. Phone/Fax
- Phone: 908-301-5491
- Fax: 908-301-5408
- Phone: 973-391-2960
- Fax: 973-391-2970
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 382273 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 26NJ00371600 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: