Provider Demographics
NPI:1124747001
Name:ALTAMIRANO, ALONDRA (RT(R) ARRT)
Entity type:Individual
Prefix:MS
First Name:ALONDRA
Middle Name:
Last Name:ALTAMIRANO
Suffix:
Gender:F
Credentials:RT(R) ARRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 108TH ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-2025
Mailing Address - Country:US
Mailing Address - Phone:718-651-4000
Mailing Address - Fax:
Practice Address - Street 1:3712 108TH ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-2025
Practice Address - Country:US
Practice Address - Phone:718-651-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5855122471M2300X
NY9341922471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography
No2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammography