Provider Demographics
NPI:1366683427
Name:LINAREZ, ALBA GUADALUPE
Entity Type:Individual
Prefix:MRS
First Name:ALBA
Middle Name:GUADALUPE
Last Name:LINAREZ
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:P.O. BOX 1176
Mailing Address - Street 2:1404 COMMONWEALTH AVE
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472
Mailing Address - Country:US
Mailing Address - Phone:646-337-8124
Mailing Address - Fax:718-931-0807
Practice Address - Street 1:1404 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472
Practice Address - Country:US
Practice Address - Phone:646-337-8124
Practice Address - Fax:718-931-0807
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor