Provider Demographics
NPI:1962279265
Name:ALZATE, HEATHER MARIE (CNM)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:ALZATE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 81ST ST APT 4K
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5071
Mailing Address - Country:US
Mailing Address - Phone:917-690-6860
Mailing Address - Fax:
Practice Address - Street 1:3521 81ST ST APT 4K
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5071
Practice Address - Country:US
Practice Address - Phone:917-690-6860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife