Individual
GLENDA YANIRA ALVAREZ TARNOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3925 PEACHTREE RD NE STE 300, BROOKHAVEN, GA 30319-5257
(404) 231-4231
Mailing address
PO BOX 769609, ROSWELL, GA 30076-8224
(770) 921-4811
(770) 921-7943
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4183
GA
363AM0700X
Medical Physician Assistant
004183
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
581762046
GA CLINIC GROUP TAX I.D.
GA
Enumeration date
12/14/2006
Last updated
01/15/2025
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