Provider Demographics
NPI:1093557753
Name:ALCIVAR, NANCY JULIE (CLW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:JULIE
Last Name:ALCIVAR
Suffix:
Gender:F
Credentials:CLW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 BROADWAY # 10-37
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:718-334-2757
Mailing Address - Fax:718-334-5006
Practice Address - Street 1:7901 BROADWAY # 10-37
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-2757
Practice Address - Fax:718-334-5006
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter