Healthcare Provider Details

I. General information

NPI: 1700876935
Provider Name (Legal Business Name): RAE M ALLAIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 09/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 CAMBRIDGE ST
BOSTON MA
02135-2907
US

IV. Provider business mailing address

690 CANTON STREET SUITE 235
WESTWOOD MA
02090-2329
US

V. Phone/Fax

Practice location:
  • Phone: 617-789-2782
  • Fax: 781-407-0998
Mailing address:
  • Phone: 781-407-7713
  • Fax: 781-407-0998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number81811
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number81811
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: