=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265625776
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KATHRYN F. ALCAREZ, D.O.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2007
-----------------------------------------------------
Last Update Date | 10/03/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 130 E 18TH ST STE 1U
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10003-2416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-420-0425
-----------------------------------------------------
Fax | 212-533-2519
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1173
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10159-1173
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-420-0425
-----------------------------------------------------
Fax | 212-533-2519
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. KATHRYN F ALCAREZ
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 212-420-0425
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | 236953
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------