MEDICARE: MRS. NELLY ALVAREZ LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R023964	NY

General Provider Information

NPI Number	:	1427188689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NELLY ALVAREZ LCSW

Provider Business Mailing Address
First Line	:	514 E 9TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-5208
Country	:	US
Telephone Number	:	718-435-0098
Fax Number	:

Provider Business Practice Location Address
First Line	:	745 64TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4753
Country	:	US
Telephone Number	:	718-283-1906
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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