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General NPI Number Information
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NPI Number | 1770307365
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Entity Type | Individual
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Provider Name | JOMILSON H ALVAREZ
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Gender | Male
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 800 ROUTE 146 STE 320
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3956
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Country | US
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Telephone | 518-553-0099
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Fax |
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Provider Business Mailing Address
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Address Line | 14C IDARED LN
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City | CLIFTON PARK
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State | NY
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Zip | 12065-4472
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Country | US
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Telephone | 305-767-6341
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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