Provider Demographics
NPI:1821350190
Name:ALSTON, NATALIE M
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:M
Last Name:ALSTON
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 1:2050 SEWARD AVE APT 8F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2141
Mailing Address - Country:US
Mailing Address - Phone:718-823-8264
Mailing Address - Fax:
Practice Address - Street 1:2050 SEWARD AVE APT 8F
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2141
Practice Address - Country:US
Practice Address - Phone:718-823-8264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist