Provider Demographics
NPI:1285364752
Name:ALARCON, ODALYS
Entity type:Individual
Prefix:
First Name:ODALYS
Middle Name:
Last Name:ALARCON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1748
Mailing Address - Country:US
Mailing Address - Phone:973-324-7879
Mailing Address - Fax:
Practice Address - Street 1:58 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6124
Practice Address - Country:US
Practice Address - Phone:201-981-8013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator