Healthcare Provider Details

I. General information

NPI: 1326975202
Provider Name (Legal Business Name): AYLA ALVES MAKRIS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 FORDHAM RD
ALLSTON MA
02134-3000
US

IV. Provider business mailing address

30 ALLSTON ST APT 25
BOSTON MA
02134-2485
US

V. Phone/Fax

Practice location:
  • Phone: 617-782-6460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.116105
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: