Basic Information
| Provider Information | |||||||||
| NPI: | 1871159715 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALVARADO HERRERA | ||||||||
| FirstName: | OSBIN | ||||||||
| MiddleName: | GILDARDO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 95000 LB# 8188 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191950001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8443621735 | ||||||||
| FaxNumber: | 9732907495 | ||||||||
| Practice Location | |||||||||
| Address1: | 181 HIGH ST | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078601020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9733839898 | ||||||||
| FaxNumber: | 9733839801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2019 | ||||||||
| LastUpdateDate: | 08/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MA11442700 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.