Healthcare Provider Details

I. General information

NPI: 1689535361
Provider Name (Legal Business Name): ANDREA ALCARAZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 QUEENS PLZ N FL 111015
LONG ISLAND CITY NY
11101-4172
US

IV. Provider business mailing address

252 CHATEAU PLACE NW
EDMONTON AB
T5T 1V3
CA

V. Phone/Fax

Practice location:
  • Phone: 718-391-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberN13405
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: