Provider Demographics
NPI:1457491920
Name:HEALEY, ALLISON B (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:B
Last Name:HEALEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4820
Mailing Address - Country:US
Mailing Address - Phone:781-356-1572
Mailing Address - Fax:
Practice Address - Street 1:115 WHITWELL ST
Practice Address - Street 2:QUINCY MEDICAL CENTER- DEPARTMENT OF SURGERY
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-1813
Practice Address - Country:US
Practice Address - Phone:617-376-3172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1647363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q36239Medicare UPIN
MAAP 2363Medicare ID - Type Unspecified