Provider Demographics
NPI:1508857863
Name:ALPERT, JONATHAN EDWARD (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:EDWARD
Last Name:ALPERT
Suffix:
Gender:M
Credentials:MD PHD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-5948
Mailing Address - Fax:617-724-5512
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WAC 812
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-5948
Practice Address - Fax:617-724-3028
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2012-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA726412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3166121Medicaid
MAJ12598OtherBCBS MA
MA725181OtherTUFTS HEALTH PLAN
MAJ12598OtherBCBS MA
MA725181OtherTUFTS HEALTH PLAN