Provider Demographics
NPI:1568670446
Name:ALEONAR, MACRISTINA VICORIA PAREJA (NP)
Entity Type:Individual
Prefix:
First Name:MACRISTINA VICORIA
Middle Name:PAREJA
Last Name:ALEONAR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:PAREJA
Other - Last Name:ALEONAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1641 3RD AVE APT 9E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3628
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:646-467-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302273363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health