Provider Demographics
NPI:1023886520
Name:ALVAREZ, MYNOR NEFTALY I (SR)
Entity type:Individual
Prefix:MR
First Name:MYNOR
Middle Name:NEFTALY
Last Name:ALVAREZ
Suffix:I
Gender:M
Credentials:SR
Other - Prefix:MR
Other - First Name:MYNOR
Other - Middle Name:NEFTALY
Other - Last Name:ALVAREZ
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:SR
Mailing Address - Street 1:126 W 55TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2225
Mailing Address - Country:US
Mailing Address - Phone:201-354-9435
Mailing Address - Fax:201-354-9436
Practice Address - Street 1:629 GROVE ST FL 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1264
Practice Address - Country:US
Practice Address - Phone:201-354-9435
Practice Address - Fax:201-354-9436
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2025-08-08
Deactivation Date:2024-06-17
Deactivation Code:
Reactivation Date:2025-08-08
Provider Licenses
StateLicense IDTaxonomies
NJHP0363000253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care