Individual
ALISA LOUISE NIKSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
750 WASHINGTON ST, THE FLOATING HOSPITAL FOR CHILDREN, #313, BOSTON, MA 02111-1526
(617) 636-5067
(617) 636-2354
Mailing address
750 WASHINGTON ST, THE FLOATING HOSPITAL FOR CHILDREN, #313, BOSTON, MA 02111-1526
(617) 636-5067
(617) 636-2354
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
036116468
IL
2080P0202X
Pediatric Cardiology Physician
Primary
243747
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116468
—
IL
05
—
243747
—
MA
Enumeration date
10/02/2006
Last updated
02/11/2011
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