Provider Demographics
NPI:1396500203
Name:ALVARADO GONZALEZ, ROSILY I (APN)
Entity type:Individual
Prefix:
First Name:ROSILY
Middle Name:I
Last Name:ALVARADO GONZALEZ
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8114 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5006
Mailing Address - Country:US
Mailing Address - Phone:201-892-0878
Mailing Address - Fax:
Practice Address - Street 1:305 E 33RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9401
Practice Address - Country:US
Practice Address - Phone:855-698-4232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311720363LA2200X
NJ26NJ14973000363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health