Healthcare Provider Details

I. General information

NPI: 1326577453
Provider Name (Legal Business Name): ALLISON REBECCA BASEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 VFW PKWY
WEST ROXBURY MA
02132-4927
US

IV. Provider business mailing address

867 WASHINGTON ST
EAST BRIDGEWATER MA
02333-1234
US

V. Phone/Fax

Practice location:
  • Phone: 857-203-6070
  • Fax:
Mailing address:
  • Phone: 508-245-9775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number272515
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: