Individual
DR. ALIA YOUSIF ANTOON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
51 BLOSSOM ST, BOSTON, MA 02114-2601
(617) 371-4720
(617) 371-4825
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
34512
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2002213
—
MA
01
—
724777
TUFTS HEALTH PLAN
MA
01
—
M08305
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
07/08/2007
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