1770705246 NPI number — MS. ADELA ALVARADO COSME SOCIAL WORKS

Table of content: MS. ADELA ALVARADO COSME SOCIAL WORKS (NPI 1770705246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770705246 NPI number — MS. ADELA ALVARADO COSME SOCIAL WORKS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALVARADO COSME
Provider First Name:
ADELA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
SOCIAL WORKS
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:
1770705246
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB.SAN MIGUEL STREET A #85
Provider Second Line Business Mailing Address:
P.O.BOX 141
Provider Business Mailing Address City Name:
SANTA ISABEL
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00757-0141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-845-5495
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WIPS ITERDISCIPLINARY GROUP
Provider Second Line Business Practice Location Address:
#70 RELAMPAGO ST.,SUITE #101
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-833-2899
Provider Business Practice Location Address Fax Number:
787-833-2899
Provider Enumeration Date:
05/03/2007

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: 104100000X , with the licence number:  #1870 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: #1870 . This is a "SOCIAL WORKS LICENSE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: CA-111-13 53248 . This is a "ADDICTION COUNSELOR 111" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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