Provider Demographics
NPI:1881796449
Name:LENNOX ALVES MD PC
Entity type:Organization
Organization Name:LENNOX ALVES MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LENNOX
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-243-0290
Mailing Address - Street 1:470 PROSPECT AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4153
Mailing Address - Country:US
Mailing Address - Phone:973-243-0290
Mailing Address - Fax:973-243-1863
Practice Address - Street 1:470 PROSPECT AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4153
Practice Address - Country:US
Practice Address - Phone:973-243-0290
Practice Address - Fax:973-243-1863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-03
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05691000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ102807Medicare PIN