Provider Demographics
NPI:1417925207
Name:ALFISHER, MARINA M (MD)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:M
Last Name:ALFISHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3904
Mailing Address - Country:US
Mailing Address - Phone:617-421-1000
Mailing Address - Fax:
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1519092085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA151909OtherTUFTS
MAJ17499OtherBCBSMA
MAP00074292OtherRAILROAD
MA245945OtherHARVARD PILGRIM
MA3161692Medicaid
MA0017137OtherNEIGHBORHOOD HEALTH
MA6403643OtherHEALTHSOURCE
MA6403643OtherCIGNA
MAG41353Medicare UPIN
MA245945OtherHARVARD PILGRIM