Provider Demographics
NPI:1538572995
Name:ALKOW, BEVERLY ROBIN (LAC)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:ROBIN
Last Name:ALKOW
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 ANDERSON AVE
Mailing Address - Street 2:APT #16M
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2177
Mailing Address - Country:US
Mailing Address - Phone:201-694-9191
Mailing Address - Fax:
Practice Address - Street 1:770 ANDERSON AVE
Practice Address - Street 2:APT #16M
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-2177
Practice Address - Country:US
Practice Address - Phone:201-694-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00106800171100000X
NY005298-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist