Provider Demographics
NPI:1336126853
Name:CRISS, ALLEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:J
Last Name:CRISS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:50 ROWE ST
Mailing Address - Street 2:STE 500
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3228
Mailing Address - Country:US
Mailing Address - Phone:781-979-3800
Mailing Address - Fax:781-662-2778
Practice Address - Street 1:50 ROWE ST
Practice Address - Street 2:STE 500
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3228
Practice Address - Country:US
Practice Address - Phone:781-979-3800
Practice Address - Fax:781-662-2778
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2008-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA29148207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB31076OtherBC/BS
MA0118982Medicaid
MAB31076OtherBC/BS
MA0118982Medicaid