MEDICARE: STEPHEN HALLISEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	278273	MA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	278273	MA

General Provider Information

NPI Number	:	1295120251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN HALLISEY

Provider Business Mailing Address
First Line	:	75 FRANCIS ST DEPT OF
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-6110
Country	:	US
Telephone Number	:	617-732-5640
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 FRANCIS ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-6106
Country	:	US
Telephone Number	:	617-732-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2015
Last Update Date	:	03/02/2026

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Directions to “ STEPHEN HALLISEY ” Practice Location

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