Provider Demographics
NPI:1508047036
Name:NAVARRO, ALTAGRACIA ALEXANDRA (PA)
Entity Type:Individual
Prefix:MRS
First Name:ALTAGRACIA
Middle Name:ALEXANDRA
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:229 W 36TH ST
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7529
Mailing Address - Country:US
Mailing Address - Phone:212-695-5122
Mailing Address - Fax:212-695-5122
Practice Address - Street 1:229 W 36TH ST
Practice Address - Street 2:10TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-7529
Practice Address - Country:US
Practice Address - Phone:212-695-5122
Practice Address - Fax:212-695-5122
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2014-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY011128363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical