Provider Demographics
NPI:1003595349
Name:PEREZ ALVARADO, BIANCA (FNP)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:PEREZ ALVARADO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:957 BROADWAY APT 202
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-7232
Mailing Address - Country:US
Mailing Address - Phone:201-699-6191
Mailing Address - Fax:
Practice Address - Street 1:1619 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-7412
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY352241363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily