Provider Demographics
NPI:1750890323
Name:ALVAREZ, LUIS (NP)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7440
Mailing Address - Country:US
Mailing Address - Phone:732-921-8534
Mailing Address - Fax:
Practice Address - Street 1:901 COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7440
Practice Address - Country:US
Practice Address - Phone:732-921-8534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00764800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner