Basic Information
| Provider Information | |||||||||
| NPI: | 1295177434 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALVES | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | BROOKE | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 46 BULL HILL RD | ||||||||
| Address2: | |||||||||
| City: | WOODSTOCK | ||||||||
| State: | CT | ||||||||
| PostalCode: | 062812310 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 202 POMFRET ST | ||||||||
| Address2: | |||||||||
| City: | PUTNAM | ||||||||
| State: | CT | ||||||||
| PostalCode: | 062601833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8609637917 | ||||||||
| FaxNumber: | 8609630015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2013 | ||||||||
| LastUpdateDate: | 10/28/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 5407 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.