Provider Demographics
NPI:1053677229
Name:RALPH J ALVAREZ, MD, PLLC
Entity Type:Organization
Organization Name:RALPH J ALVAREZ, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-986-6969
Mailing Address - Street 1:9 GRAND ST
Mailing Address - Street 2:PO BOX 405
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1007
Mailing Address - Country:US
Mailing Address - Phone:845-986-6969
Mailing Address - Fax:845-986-0024
Practice Address - Street 1:9 GRAND ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1007
Practice Address - Country:US
Practice Address - Phone:845-986-6969
Practice Address - Fax:845-986-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168391261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY168391OtherNYS MEDICAL LICENSE NUMBER