Provider Demographics
NPI:1265625776
Name:KATHRYN F. ALCAREZ, D.O.
Entity type:Organization
Organization Name:KATHRYN F. ALCAREZ, D.O.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALCAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:212-420-0425
Mailing Address - Street 1:PO BOX 1173
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10159-1173
Mailing Address - Country:US
Mailing Address - Phone:212-420-0425
Mailing Address - Fax:212-533-2519
Practice Address - Street 1:130 E 18TH ST STE 1U
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2416
Practice Address - Country:US
Practice Address - Phone:212-420-0425
Practice Address - Fax:212-533-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236953261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2600544OtherUNITED
NY7687797OtherAETNA PPO
NYP3806309OtherOXFORD
NY1181062OtherAETNA HMO
NY02692780Medicaid
NYP3806309OtherOXFORD
NY7687797OtherAETNA PPO