Provider Demographics
NPI:1881644250
Name:ALPHA NEUROLOGY,PC
Entity Type:Organization
Organization Name:ALPHA NEUROLOGY,PC
Other - Org Name:NEW DORP MRI & IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:PEREL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-667-3597
Mailing Address - Street 1:27 NEW DORP LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2322
Mailing Address - Country:US
Mailing Address - Phone:718-667-3597
Mailing Address - Fax:718-667-3590
Practice Address - Street 1:27 NEW DORP LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2322
Practice Address - Country:US
Practice Address - Phone:718-667-3597
Practice Address - Fax:718-667-3590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1672032084N0400X
NY1966282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02712774Medicaid
NYWG2841Medicare PIN