Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 219826 | MA |
NPI | 1053302604 |
---|---|
Provider Name | Dr. Allison Bailey |
First Address | Charlestown, MA 02129-9142 |
Second Address | Medford, MA 02155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 24/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2031647 | (05) | MA |
468721 | TUFTS HEALTH PLAN (01) | MA |
I10314 | (02) | |
J27061 | BCBS MA (01) |