Green, Alysia L
Green, Alysia L is an individual health care provider with primary practice located at 915 Commonwealth Ave Rear , Boston MA 02215-1394. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Green, Alysia L can be contacted via phone (617) 358-3400.Contact Information
Primary practice address
915 Commonwealth Ave Rear
Boston MA 02215-1394
Phone: (617) 358-3400
Fax: (617) 358-3710
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 232853 | Massachusetts |
Profile Details
| NPI number | 1013124296 |
|---|---|
| LBN Legal business name | Green, Alysia L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2007 |
| Last updated | Apr 6th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013124296 | NPPES |
| Massachusetts | MEDICAID | 110076162A |
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