Healthcare Provider Details

I. General information

NPI: 1992192793
Provider Name (Legal Business Name): ALPHA COMMUNICATIONS OF LI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

953 SOUTHERN BLVD SUITE 204
BRONX NY
10459
US

IV. Provider business mailing address

78-02 65 ST
GLENDALE NY
11385
US

V. Phone/Fax

Practice location:
  • Phone: 718-542-0472
  • Fax: 718-709-7652
Mailing address:
  • Phone: 917-304-7433
  • Fax: 718-709-7652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: JOSE LUIS SANTAMARA
Title or Position: DME VENDOR
Credential:
Phone: 917-304-7433