Provider Demographics
NPI:1093997371
Name:ALVAREZ, LAURA JULIA (FNP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:JULIA
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:JULIA
Other - Last Name:VAZQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:420 BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-3610
Mailing Address - Country:US
Mailing Address - Phone:917-306-8991
Mailing Address - Fax:
Practice Address - Street 1:5141 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1159
Practice Address - Country:US
Practice Address - Phone:212-305-0319
Practice Address - Fax:212-392-4328
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334602363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily