Provider Demographics
NPI:1275996985
Name:ALVAREZ, ROSEMARY
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 FOREST PARK
Mailing Address - Street 2:
Mailing Address - City:WALLKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12589-4247
Mailing Address - Country:US
Mailing Address - Phone:845-883-0381
Mailing Address - Fax:
Practice Address - Street 1:21 MAINE DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1886
Practice Address - Country:US
Practice Address - Phone:845-245-4649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY542857374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide