1992192793 NPI number — ALPHA COMMUNICATIONS OF LI INC

Table of content: (NPI 1992192793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992192793 NPI number — ALPHA COMMUNICATIONS OF LI INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALPHA COMMUNICATIONS OF LI INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1992192793
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
78-02 65 ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11385
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-304-7433
Provider Business Mailing Address Fax Number:
718-709-7652

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
953 SOUTHERN BLVD
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-542-0472
Provider Business Practice Location Address Fax Number:
718-709-7652
Provider Enumeration Date:
04/20/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SANTAMARA
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
LUIS
Authorized Official Title or Position:
DME VENDOR
Authorized Official Telephone Number:
917-304-7433

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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