Provider Demographics
NPI:1639463375
Name:ALTRECHE, MARIA ESTHER
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ESTHER
Last Name:ALTRECHE
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:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0063
Mailing Address - Country:US
Mailing Address - Phone:787-447-9571
Mailing Address - Fax:
Practice Address - Street 1:2097 AVE HOSTOS
Practice Address - Street 2:UNIVERSITY PLAZA
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6440
Practice Address - Country:US
Practice Address - Phone:787-805-4805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-29
Last Update Date:2011-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1894183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist