MEDICARE: CRISTOBAL G ALVARADO MD

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	208600000X	Surgery Physician	C1-0007299	DE
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	018306	ME
3	208600000X	Surgery Physician	018306	ME
4	2086S0129X	Vascular Surgery Physician	018306	ME
5	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD18306	ME
6	2086S0129X	Vascular Surgery Physician	MD18306	ME
7	208600000X	Surgery Physician	MD18306	ME
8	208600000X	Surgery Physician	051650	CT
9	2086S0129X	Vascular Surgery Physician	051650	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00174912	OTHER	DE	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578530333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTOBAL G ALVARADO MD

Provider Business Mailing Address
First Line	:	455 LEWIS AVE
Second Line	:	SUITE 203
City	:	MERIDEN
State	:	CT
Zip	:	06451-2121
Country	:	US
Telephone Number	:	203-634-1900
Fax Number	:	203-237-8441

Provider Business Practice Location Address
First Line	:	455 LEWIS AVE
Second Line	:	SUITE 203
City	:	MERIDEN
State	:	CT
Zip	:	06451-2121
Country	:	US
Telephone Number	:	203-634-1900
Fax Number	:	203-237-8441

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

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	01/06/2014

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