1891412789 NPI number — ANA YANCI ALVARENGA

Table of content: ANA YANCI ALVARENGA (NPI 1891412789)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891412789 NPI number — ANA YANCI ALVARENGA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALVARENGA
Provider First Name:
ANA
Provider Middle Name:
YANCI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891412789
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4513 APEX LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELTSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20705-1571
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-825-6903
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 MICHIGAN AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH EAST
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-839-6094
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 372600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)