Individual
ALEXANDER REAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
291 NAHANTON ST, NEWTON, MA 02459-2900
(617) 694-0820
Mailing address
291 NAHANTON ST, NEWTON, MA 02459-2900
(617) 694-0820
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S37078985
RMV LICENSE
MA
Enumeration date
05/16/2022
Last updated
05/16/2022
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