Individual
DR. KENNETH W ALPHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1850 S TOWNSHIP BLVD, SUITE 6, PITTSTON, PA 18640
(570) 654-1641
(570) 654-2835
Mailing address
200 MIFFLIN AVE, SCRANTON, PA 18503
(570) 342-3145
(570) 344-1309
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000865
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001240520
—
PA
01
—
072343
FIRST PRIORITY HEALTH
—
01
—
20987
GEISINGER HEALTH PLAN
—
01
—
410024725
RAILROAD MEDICARE
—
01
—
506554
AETNA
—
01
—
AL513333
HIGH MARK BLUE SHIELD
—
Enumeration date
08/13/2006
Last updated
01/05/2010
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