Provider Demographics
NPI:1114362589
Name:ANDERSON-ALVAREZ, JOANNE MILLER (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:MILLER
Last Name:ANDERSON-ALVAREZ
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13930 246TH ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2225
Mailing Address - Country:US
Mailing Address - Phone:718-528-0542
Mailing Address - Fax:
Practice Address - Street 1:13930 246TH ST
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:NY
Practice Address - Zip Code:11422-2225
Practice Address - Country:US
Practice Address - Phone:718-528-0542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY527976163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant