Provider Demographics
NPI:1689878951
Name:ALPHA MEDICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:ALPHA MEDICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OLNREWAJU
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEOSUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-649-6324
Mailing Address - Street 1:8925 FLATLANDS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3613
Mailing Address - Country:US
Mailing Address - Phone:718-649-6324
Mailing Address - Fax:
Practice Address - Street 1:8925 FLATLANDS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3613
Practice Address - Country:US
Practice Address - Phone:718-649-6324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203510207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty