| Alyeska Family Medicine Inc | |
|
3841 Piper Street Suite T3162 Anchorage AK 99508 | |
| (907) 258-1258 | |
| (907) 258-1257 |
| Full Name | Alyeska Family Medicine Inc |
|---|---|
| Speciality | General Practice |
| Location | 3841 Piper Street, Anchorage, Alaska |
| Authorized Official Name and Position | Mario A Lanza (PRESIDENT) |
| Authorized Official Contact | 9072581258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alyeska Family Medicine Inc 3841 Piper Street Suite T3162 Anchorage AK 99508 Ph: (907) 258-1258 | Alyeska Family Medicine Inc 3841 Piper Street Suite T3162 Anchorage AK 99508 Ph: (907) 258-1258 |
| NPI Number | 1447451737 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 02/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447451737 | NPI | - | NPPES |
| 161169 | Other | AK | PTAN |
| 161406 | Other | AK | MEDICARE PTAN |
| MD3385 | Medicaid | AK | |
| MD37532 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 3753 (Alaska) | Primary |
| 208D00000X | General Practice | 3905 (Alaska) | Secondary |
| 208D00000X | General Practice | 4503 (Alaska) | Secondary |
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