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General NPI Number Information
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NPI Number | 1740703834
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Entity Type | Individual
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Provider Name | MARISSA LUCIA ALVAREZ NP
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Gender | Female
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 04/29/2023
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Provider Practice Location Address
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Address Line | 5645 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-5045
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Country | US
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Telephone | 347-343-1656
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Fax |
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Provider Business Mailing Address
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Address Line | 834 NEWPORT CIR
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City | REDWOOD CITY
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State | CA
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Zip | 94065-1913
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Country | US
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Telephone | 650-464-8231
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F402499
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 720492-1
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License Number State | NY
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