Basic Information
Provider Information
NPI: 1205361763
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PISIG
FirstName: ALEX
MiddleName: UMALI
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13 ALCALDE JOSE STREET KAPASIGAN
Address2:  
City: PASIG
State: METRO MANILA
PostalCode: 1600
CountryCode: PH
TelephoneNumber: 09157502869
FaxNumber:  
Practice Location
Address1: ONE JOSLIN PLACE
Address2: BEETHAM EYE INSTITUTE, JOSLIN DIABETES CENTER
City: BOSTON
State: MA
PostalCode: 02215
CountryCode: US
TelephoneNumber: 6173092520
FaxNumber: 6173092545
Other Information
ProviderEnumerationDate: 04/21/2017
LastUpdateDate: 04/21/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207WX0107X270367MAY    

No ID Information.


Home