MEDICARE: LESLIE THERESE 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	208000000X	Pediatrics Physician	202161	NY

General Provider Information

NPI Number	:	1578540639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE THERESE ALVARADO MD

Provider Business Mailing Address
First Line	:	8008 3RD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3802
Country	:	US
Telephone Number	:	718-833-3636
Fax Number	:	718-833-2432

Provider Business Practice Location Address
First Line	:	8008 3RD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3802
Country	:	US
Telephone Number	:	718-833-3636
Fax Number	:	718-833-2432

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

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	04/01/2011

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