Provider Demographics
NPI:1457466781
Name:LUZ F. ALVAREZ, MD PLLC
Entity Type:Organization
Organization Name:LUZ F. ALVAREZ, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:FABIOLA
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-843-4393
Mailing Address - Street 1:425 GUY PARK AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-1043
Mailing Address - Country:US
Mailing Address - Phone:518-843-4393
Mailing Address - Fax:518-842-1618
Practice Address - Street 1:425 GUY PARK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-1043
Practice Address - Country:US
Practice Address - Phone:518-843-4393
Practice Address - Fax:518-842-1618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168586207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01184601Medicaid
NY01184601Medicaid