Provider Demographics
NPI:1932314739
Name:ALVEAR, RUTH MARLENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:MARLENE
Last Name:ALVEAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5117 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4540
Mailing Address - Country:US
Mailing Address - Phone:718-639-8932
Mailing Address - Fax:718-639-1434
Practice Address - Street 1:5117 43RD AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-4540
Practice Address - Country:US
Practice Address - Phone:718-639-8932
Practice Address - Fax:718-639-1434
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044882-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01468560Medicaid