Healthcare Provider Details

I. General information

NPI: 1437095007
Provider Name (Legal Business Name): KATHLEEN ALZATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97-09 211ST ST
QUEENS VILLAGE NY
11429
US

IV. Provider business mailing address

97-09 211ST ST
QUEENS VILLAGE NY
11429
US

V. Phone/Fax

Practice location:
  • Phone: 516-903-1207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: