Healthcare Provider Details
I. General information
NPI: 1427636901
Provider Name (Legal Business Name): JAQUELINE ALVARADO-VALADEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/29/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
577 PROSPECT AVE APT 1B
BROOKLYN NY
11215-6074
US
IV. Provider business mailing address
577 PROSPECT AVE APT 1B
BROOKLYN NY
11215-6074
US
V. Phone/Fax
- Phone: 212-420-2000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | 344286 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: