Healthcare Provider Details

I. General information

NPI: 1679140776
Provider Name (Legal Business Name): ALEXANDRA ALVAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W PASSAIC ST
ROCHELLE PARK NJ
07662-3105
US

IV. Provider business mailing address

151 W PASSAIC ST
ROCHELLE PARK NJ
07662-3105
US

V. Phone/Fax

Practice location:
  • Phone: 201-644-6331
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06293700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: