Provider Demographics
NPI:1083795165
Name:FREED, ALISA A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISA
Middle Name:A
Last Name:FREED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:143 LONGWATER DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1795
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:
Practice Address - Street 1:143 LONGWATER DRIVE
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1795
Practice Address - Country:US
Practice Address - Phone:781-878-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230474207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042297845OtherGIC/UNICARE
042297845OtherUNITED HEALTH CARE
042297845OtherTRICARE
3666503OtherCIGNA
496345OtherTUFTS AND TUFTS MEDICARE PREFERRED
7621961OtherAETNA
042297845OtherHCVM
1083795165OtherNEIGHBORHOOD HEALTH PLAN
9334002OtherNETWORK HEALTH
AA316916OtherHARVARD PILGRIM
MAJ41896OtherBCBSMA
MA1083795165OtherFALLON
MA1083795165Medicaid
042297845OtherHCVM