ALYESKA FAMILY MEDICINE INC NPI 1447451737

NPI Information

NPI: 1447451737
Provider Name: ALYESKA FAMILY MEDICINE INC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 02D1052312

Address:
3841 PIPER STREET
SUITE T3162
ANCHORAGE, AK
ZIP 99508
Phone: (907) 258-1258
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ALYESKA FAMILY MEDICINE INC is a general practice in Anchorage, AK. ALYESKA FAMILY MEDICINE INC NPI is 1447451737. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3841 PIPER STREET
SUITE T3162
ANCHORAGE, AK
ZIP 99508
Phone: (907) 258-1258
Fax: (907) 258-1257

The provider's authorized official is Mario A Lanza .
The authorized official title is President and has the following contact phone number (907) 258-1258.

The CLIA number assigned to this NPI record is 02D1052312 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2007 and was last updated on 2/26/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	208D00000X	General Practice	3905	ALASKA	No
2	208D00000X	General Practice	4503	ALASKA	No
3	208D00000X	General Practice	3753	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	161406	OTHER	ALASKA	MEDICARE PTAN
2	160659	MEDICARE ID-TYPE UNSPECIFIED	ALASKA	MARIO LANZA, MD
3	161169	OTHER	ALASKA	PTAN
4	MD37532	MEDICAID	ALASKA
5	MD3385	MEDICAID	ALASKA
6	G42622	MEDICARE UPIN	ALASKA
7	K160658	MEDICARE PIN	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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