Provider Demographics
NPI:1144844812
Name:SANTOS-ALVAREZ, CHARLENE (NP)
Entity type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:
Last Name:SANTOS-ALVAREZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8450 169TH ST APT 502
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2018
Mailing Address - Country:US
Mailing Address - Phone:347-651-9908
Mailing Address - Fax:
Practice Address - Street 1:8450 169TH ST APT 502
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-2018
Practice Address - Country:US
Practice Address - Phone:347-651-9908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF421015-01363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health