Provider Demographics
NPI:1740038637
Name:ALVARADO-CORTES, JOSE A (LPN)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:A
Last Name:ALVARADO-CORTES
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:MR
Other - First Name:JOSE
Other - Middle Name:A
Other - Last Name:ALVARADO-CORTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:433 LARCHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-2434
Mailing Address - Country:US
Mailing Address - Phone:479-640-3138
Mailing Address - Fax:
Practice Address - Street 1:433 LARCHMONT AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-2434
Practice Address - Country:US
Practice Address - Phone:479-640-3138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330676-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse