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General NPI Number Information
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NPI Number | 1134416860
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Entity Type | Individual
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Provider Name | ALPH JO EMMANUEL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2011
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 140 SHERMAN ST FL 2
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City | FAIRFIELD
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State | CT
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Zip | 06824-5849
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Country | US
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Telephone | 860-840-1819
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Fax |
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Provider Business Mailing Address
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Address Line | 27 BROOKSIDE AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-4006
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Country | US
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Telephone | 860-840-1819
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 313539
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA10824500
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 56655
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License Number State | CT
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