Niksch, Alisa Louise

Niksch, Alisa Louise is an individual health care provider with primary practice located at 750 Washington St The Floating Hospital For Children, #313, Boston MA 02111-1526. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as her primary health care specialty. Niksch, Alisa Louise can be contacted via phone (617) 636-5067.

Contact Information

Primary practice address
750 Washington St The Floating Hospital For Children, #313 Boston MA 02111-1526
Phone: (617) 636-5067
Fax: (617) 636-2354
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 036116468 Illinois
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 243747 Massachusetts

Profile Details

NPI number 1336232255
LBN Legal business name Niksch, Alisa Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Feb 11th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336232255 NPPES
Massachusetts MEDICAID 243747
Massachusetts MEDICAID 036116468

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