Provider Demographics
NPI:1386342889
Name:ALPHA MENS CLINIC PC
Entity type:Organization
Organization Name:ALPHA MENS CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-431-5978
Mailing Address - Street 1:357 S GULPH RD STE 230
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3177
Mailing Address - Country:US
Mailing Address - Phone:484-685-1301
Mailing Address - Fax:
Practice Address - Street 1:357 S GULPH RD STE 230
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3177
Practice Address - Country:US
Practice Address - Phone:484-685-1301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center