Provider Demographics
NPI:1073649604
Name:ALVAREZ, JUDITH A
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:A
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:ALONSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:THREE BRIDGES
Mailing Address - State:NJ
Mailing Address - Zip Code:08887-0310
Mailing Address - Country:US
Mailing Address - Phone:908-806-2000
Mailing Address - Fax:908-806-2003
Practice Address - Street 1:361 STATE ROUTE 31
Practice Address - Street 2:BUILDING C, SUITE 804
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5712
Practice Address - Country:US
Practice Address - Phone:908-806-2000
Practice Address - Fax:908-806-2003
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01216900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist