Individual
LISA J VUKALCIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
736 CAMBRIDGE STREET, BOSTON, MA 02135-2907
(617) 789-2782
(907) 258-2147
Mailing address
690 CANTON STREET, SUITE 325, WESTWOOD, MA 02090-2329
(781) 407-7713
(781) 407-0998
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
246553
MA
207L00000X
Anesthesiology Physician
3105
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050064949
MEDICARE RAILROAD
AK
01
—
8428476
WA MEDICAID
WA
01
—
995202149
OFFICE OF WORKER'S COMP
WA
05
—
MD50901
—
AK
Enumeration date
10/11/2005
Last updated
12/14/2011
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