Individual
ALISA B ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
732 HARRISON AVE, PRESTON, 3RD FLOOR, BOSTON, MA 02118-2309
(617) 638-7490
(617) 414-8742
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
220626
MA
207RC0000X
Cardiovascular Disease Physician
Primary
220626
MA
207UN0901X
Nuclear Cardiology Physician
220626
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110075655A
—
MA
Enumeration date
12/01/2006
Last updated
06/13/2014
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