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General NPI Number Information
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NPI Number | 1083795165
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Entity Type | Individual
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Provider Name | ALISA A FREED M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 01/16/2014
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Provider Practice Location Address
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Address Line | 143 LONGWATER DRIVE
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City | NORWELL
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State | MA
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Zip | 02061-1795
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Country | US
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Telephone | 781-878-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 143 LONGWATER DRIVE
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City | NORWELL
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State | MA
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Zip | 02061-1795
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Country | US
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Telephone | 781-878-5200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 230474
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License Number State | MA
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