Healthcare Provider Details

I. General information

NPI: 1417878901
Provider Name (Legal Business Name): ALIREZA KALBASI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W 5TH ST APT 5G
BOSTON MA
02127-3351
US

IV. Provider business mailing address

20 W 5TH ST APT 5G
BOSTON MA
02127-3351
US

V. Phone/Fax

Practice location:
  • Phone: 617-775-9923
  • Fax:
Mailing address:
  • Phone: 617-775-9923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH237678
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: