MEDICARE: ALLIANCE WELLCARE PLLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1790526986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE WELLCARE PLLC

Provider Business Mailing Address
First Line	:	240 BEAR HILL RD STE 104
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-1026
Country	:	US
Telephone Number	:	781-249-8007
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 BEAR HILL RD STE 104
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-1026
Country	:	US
Telephone Number	:	781-249-8007
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SAMSON EBHO OSEBOR
Credential	:	PMHNP
Telephone Number	:	781-249-8007

Provider Enumeration Date	:	06/03/2024
Last Update Date	:	06/03/2024

Similar Medicare Providers

1023854213 — LISA SHRESTHA NP
Practice Location Address:

240 BEAR HILL RD STE 104
WALTHAM, MA
02451-1026

Practice Phone: 781-775-9111
Practice Fax:

1649805607 — GLOBAL BEHAVIORAL HEALTHCARE LLC
Practice Location Address:

240 BEAR HILL RD STE 104
WALTHAM, MA
02451-1026

Practice Phone: 857-312-5626
Practice Fax:

1578298907 — MR. SAMSON EBHO OSEBOR RN
Practice Location Address:

240 BEAR HILL RD STE 104
WALTHAM, MA
02451-1026

Practice Phone: 617-340-3559
Practice Fax:

1639038177 — GANESH MOORTHY
Practice Location Address:

35 GATEHOUSE DR
WALTHAM, MA
02451-1215

Practice Phone: 781-839-2848
Practice Fax:

1609238633 — CARL WILKINS MD
Practice Location Address:

1440 MAIN ST STE 201
WALTHAM, MA
02451-1634

Practice Phone: 781-891-6377
Practice Fax: 781-647-1430

1760242630 — DIANE ALHAFEZ
Practice Location Address:

879 MAIN ST
WALTHAM, MA
02451-7414

Practice Phone: 781-850-2361
Practice Fax:

Directions to “ALLIANCE WELLCARE PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.