=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689535361
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREA ALCARAZ RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/21/2025
-----------------------------------------------------
Last Update Date | 11/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2811 QUEENS PLZ N FL 111015
-----------------------------------------------------
City | LONG ISLAND CITY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11101-4172
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-391-8300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 252 CHATEAU PLACE NW
-----------------------------------------------------
City | EDMONTON
-----------------------------------------------------
State | AB
-----------------------------------------------------
Zip | T5T 1V3
-----------------------------------------------------
Country | CA
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WS0200X
-----------------------------------------------------
Taxonomy Name | School Registered Nurse
-----------------------------------------------------
License Number | N13405
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------