Provider Demographics
NPI:1902118839
Name:ALVAREZ, EDUARDO J I
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:J
Last Name:ALVAREZ
Suffix:I
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 1:309 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4842
Mailing Address - Country:US
Mailing Address - Phone:973-429-0020
Mailing Address - Fax:973-429-0719
Practice Address - Street 1:309 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4842
Practice Address - Country:US
Practice Address - Phone:973-429-0020
Practice Address - Fax:973-429-0719
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0127200251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health