Provider Demographics
NPI:1831302074
Name:DURANALVARADO, ALEX ALFREDO SR (IDC)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:ALFREDO
Last Name:DURANALVARADO
Suffix:SR
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 TURNERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-6553
Mailing Address - Country:US
Mailing Address - Phone:856-722-6170
Mailing Address - Fax:
Practice Address - Street 1:300 CENTERTON RD
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3825
Practice Address - Country:US
Practice Address - Phone:856-722-6170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman