Provider Demographics
NPI:1275653016
Name:TATIANA HAMAWI, DBA ALPHA-OMEGA MEDICAL CARE
Entity Type:Organization
Organization Name:TATIANA HAMAWI, DBA ALPHA-OMEGA MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMAWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-753-7700
Mailing Address - Street 1:121 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2429
Mailing Address - Country:US
Mailing Address - Phone:508-753-7700
Mailing Address - Fax:508-753-7737
Practice Address - Street 1:121 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2429
Practice Address - Country:US
Practice Address - Phone:508-753-7700
Practice Address - Fax:508-753-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152836207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3188302Medicaid
MAG57673Medicare UPIN
MAA23778Medicare ID - Type Unspecified