Provider Demographics
NPI:1780038869
Name:ALVES, TRACEY (APN)
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:
Last Name:ALVES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:TRACEY
Other - Middle Name:
Other - Last Name:ALVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1308 MORRIS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1308 MORRIS AVE STE 102
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3328
Practice Address - Country:US
Practice Address - Phone:908-265-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00633900363LF0000X
NJ26NR15849800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse