Provider Demographics
NPI:1417080870
Name:ALVAREZ, WILLIAM M (PT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 23RD ST
Mailing Address - Street 2:APT 3A
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4100
Mailing Address - Country:US
Mailing Address - Phone:217-516-0600
Mailing Address - Fax:
Practice Address - Street 1:3211 23RD ST
Practice Address - Street 2:APT 3A
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-4100
Practice Address - Country:US
Practice Address - Phone:217-516-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008904A225100000X
NY027806-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist