MEDICARE: MR. DILLON CLARK KALIRIS MSN, APRN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN10014494	MA

General Provider Information

NPI Number	:	1750212924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DILLON CLARK KALIRIS MSN, APRN, FNP-BC

Provider Business Mailing Address
First Line	:	4 FAIRMOUNT ST
Second Line	:
City	:	MELROSE
State	:	MA
Zip	:	02176-4813
Country	:	US
Telephone Number	:	781-856-5815
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 FAIRMOUNT ST
Second Line	:
City	:	MELROSE
State	:	MA
Zip	:	02176-4813
Country	:	US
Telephone Number	:	781-856-5815
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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