Provider Demographics
NPI:1104294057
Name:ALVAREZ, HECTOR
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 ASTORIA BLVD
Mailing Address - Street 2:APT 2L
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1160
Mailing Address - Country:US
Mailing Address - Phone:646-269-8701
Mailing Address - Fax:
Practice Address - Street 1:3210 ASTORIA BLVD
Practice Address - Street 2:APT 2L
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1160
Practice Address - Country:US
Practice Address - Phone:646-269-8701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY969662151174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist