Provider Demographics
NPI:1457067464
Name:ALVAREZ, SAMAYRA I
Entity Type:Individual
Prefix:MRS
First Name:SAMAYRA
Middle Name:I
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 1:1 MARKET ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1044
Mailing Address - Country:US
Mailing Address - Phone:781-592-0540
Mailing Address - Fax:781-592-0989
Practice Address - Street 1:1 MARKET ST STE 3
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1044
Practice Address - Country:US
Practice Address - Phone:781-592-0540
Practice Address - Fax:781-592-0989
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10063225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant