Provider Demographics
NPI:1962045559
Name:ALOFA, SIAOSI
Entity Type:Individual
Prefix:
First Name:SIAOSI
Middle Name:
Last Name:ALOFA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 E 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-2908
Mailing Address - Country:US
Mailing Address - Phone:907-744-2051
Mailing Address - Fax:
Practice Address - Street 1:1905 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-2908
Practice Address - Country:US
Practice Address - Phone:907-744-2051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider