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General NPI Number Information
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NPI Number | 1083136360
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Entity Type | Individual
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Provider Name | ALVARO TAMAYO GUTIERREZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/08/2017
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 377 ONDERDONK AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-1324
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Country | US
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Telephone | 917-854-9516
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Fax |
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Provider Business Mailing Address
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Address Line | 10700 MCPHERSON RD
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City | LAREDO
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State | TX
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Zip | 78045-6268
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Country | US
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Telephone | 440-542-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | T5468
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | T5468
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License Number State | TX
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