Healthcare Provider Details

I. General information

NPI: 1356527899
Provider Name (Legal Business Name): MARTA ALVAREZ RPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W KINGSBRIDGE RD
BRONX NY
10468-3904
US

IV. Provider business mailing address

40 E COLUMBIA AVE APT 8A
PALISADES PARK NJ
07650-1484
US

V. Phone/Fax

Practice location:
  • Phone: 718-584-9000
  • Fax:
Mailing address:
  • Phone: 201-313-5961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number5886
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number300101041156320
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: