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General NPI Number Information
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NPI Number | 1639622269
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Entity Type | Organization
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Legal Business Name | GILBERTO ALVAREZ DEL MANZANO DERMATOLOGY PLLC
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 291 BROADWAY RM 1803
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City | NEW YORK
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State | NY
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Zip | 10007-1889
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Country | US
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Telephone | 212-233-2995
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Fax |
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Provider Business Mailing Address
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Address Line | 291 BROADWAY RM 1803
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City | NEW YORK
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State | NY
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Zip | 10007-1889
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Country | US
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Telephone | 212-233-2995
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Fax |
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. GILBERTO ALVAREZ DEL MANZANO
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Credential | MD
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Telephone | 212-233-2995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 265513
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License Number State | NY
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