Provider Demographics
NPI:1215696448
Name:SA ALVES, ALEXANDRE M
Entity type:Individual
Prefix:
First Name:ALEXANDRE
Middle Name:M
Last Name:SA ALVES
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 1:132 STATE ROUTE 37 STE A
Mailing Address - Street 2:
Mailing Address - City:NEW FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06812-4053
Mailing Address - Country:US
Mailing Address - Phone:203-297-5399
Mailing Address - Fax:
Practice Address - Street 1:132 STATE ROUTE 37 STE A
Practice Address - Street 2:
Practice Address - City:NEW FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06812-4053
Practice Address - Country:US
Practice Address - Phone:203-297-5399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist