Basic Information
| Provider Information | |||||||||
| NPI: | 1336756055 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALVAREZ | ||||||||
| FirstName: | EMILY | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 707 6TH ST | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197118717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025593884 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 S CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199561571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3022806953 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2020 | ||||||||
| LastUpdateDate: | 09/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | J2-0011417 | DE | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.