Provider Demographics
NPI:1588176465
Name:ALCANTARA, MARIA ELENA (MSN, ANP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:MSN, ANP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ELENA
Other - Last Name:ALCANTARA ARIAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:288 BOULEVARD STE 2
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-1319
Mailing Address - Country:US
Mailing Address - Phone:201-288-6781
Mailing Address - Fax:201-288-2734
Practice Address - Street 1:288 BOULEVARD STE 2
Practice Address - Street 2:
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604-1319
Practice Address - Country:US
Practice Address - Phone:201-288-6781
Practice Address - Fax:201-288-2734
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00775000363LA2200X, 363LG0600X, 363L00000X
NYF308507363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care