Provider Demographics
NPI:1821713090
Name:ALVAREZ, YEISSI A
Entity Type:Individual
Prefix:
First Name:YEISSI
Middle Name:A
Last Name:ALVAREZ
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 1:821C TRINITY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-7754
Mailing Address - Country:US
Mailing Address - Phone:646-342-6620
Mailing Address - Fax:
Practice Address - Street 1:821C TRINITY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-7754
Practice Address - Country:US
Practice Address - Phone:646-342-6629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000OtherNY
NYNAMedicaid