Provider Demographics
NPI:1639622269
Name:GILBERTO ALVAREZ DEL MANZANO DERMATOLOGY PLLC
Entity Type:Organization
Organization Name:GILBERTO ALVAREZ DEL MANZANO DERMATOLOGY PLLC
Other - Org Name:DOWNTOWN DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GILBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ DEL MANZANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-233-2995
Mailing Address - Street 1:291 BROADWAY RM 1803
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1889
Mailing Address - Country:US
Mailing Address - Phone:212-233-2995
Mailing Address - Fax:
Practice Address - Street 1:291 BROADWAY RM 1803
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1889
Practice Address - Country:US
Practice Address - Phone:212-233-2995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265513207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty