Provider Demographics
NPI:1215304878
Name:ALPHA CAPRICORNUS INC
Entity type:Organization
Organization Name:ALPHA CAPRICORNUS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:OLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINEBAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-415-9508
Mailing Address - Street 1:10 PYRAMID CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-7224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:423 ROUTE 59 STE 1&2
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952-2859
Practice Address - Country:US
Practice Address - Phone:212-518-1416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-29
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies