Healthcare Provider Details

I. General information

NPI: 1952540791
Provider Name (Legal Business Name): ALLISON MARIE VALLARELLI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 02/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 PARK AVENUE EXT APT 2
ARLINGTON MA
02474-2656
US

IV. Provider business mailing address

63 PARK AVENUE EXT APT 2
ARLINGTON MA
02474-2656
US

V. Phone/Fax

Practice location:
  • Phone: 617-909-3686
  • Fax:
Mailing address:
  • Phone: 617-909-3686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number270386
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: