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NPI Code Detail

MEDICARE: MS. IVETTE ALVALLE

MEDICARE: MS. IVETTE ALVALLE
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

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

General Provider Information

NPI Number : 1639346679
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. IVETTE ALVALLE
Provider Business Mailing Address
First Line : 930 OGDEN AVE
Second Line :
City : BRONX
State : NY
Zip : 10452-5548
Country : US
Telephone Number : 347-510-3618
Fax Number :
Provider Business Practice Location Address
First Line : 2976 NORTHERN BLVD
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-2822
Country : US
Telephone Number : 347-510-3618
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2008
Last Update Date : 05/09/2008

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