Provider Demographics
NPI:1649403031
Name:ALLIANCE BEHAVIORAL MEDICINE,LLC
Entity Type:Organization
Organization Name:ALLIANCE BEHAVIORAL MEDICINE,LLC
Other - Org Name:RAMZI M NASSAR, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMZI
Authorized Official - Middle Name:M
Authorized Official - Last Name:NASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-562-0001
Mailing Address - Street 1:2440 E TUDOR RD
Mailing Address - Street 2:PMB 1145
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1185
Mailing Address - Country:US
Mailing Address - Phone:907-746-6962
Mailing Address - Fax:907-746-6961
Practice Address - Street 1:4048 LAUREL ST
Practice Address - Street 2:SUITE 305
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5389
Practice Address - Country:US
Practice Address - Phone:907-562-0001
Practice Address - Fax:907-562-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK35222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD22532Medicaid