=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649050808
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ISABEL AURELIA ALVAREZ PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2023
-----------------------------------------------------
Last Update Date | 10/04/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 441 VALLEY BROOK AVE
-----------------------------------------------------
City | LYNDHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07071-1935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-935-1338
-----------------------------------------------------
Fax | 201-935-1027
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 441 VALLEY BROOK AVE
-----------------------------------------------------
City | LYNDHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07071-1935
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-935-1338
-----------------------------------------------------
Fax | 201-935-1027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 28RI04327800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------