Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 229965 | NY |
N | 207RC0200X | Critical Care Medicine | D65179 | MD |
N | 207RC0200X | Critical Care Medicine | MD2012-0867 | NM |
N | 207RP1001X | Pulmonary Disease | 036-150072 | IL |
N | 207RP1001X | Pulmonary Disease | 229965 | NY |
N | 207RP1001X | Pulmonary Disease | D65179 | MD |
Y | 207RP1001X | Pulmonary Disease | MD2012-0867 | NM |
NPI | 1023034196 |
---|---|
Provider Name | Dr. Vanessa Alvarez |
First Address | Elgin, IL 60123-9402 |
Second Address | Albuquerque, NM 87102-2534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 29/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02751453 | (05) | NY |
41886046 | (05) | NM |
I55240 | (02) | NY |