Provider Demographics
NPI:1518963552
Name:ALLAN, ANNE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:ELIZABETH
Last Name:ALLAN
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:ONE CRANBERRY HILL, SUITE 303
Mailing Address - Street 2:STRATA DIAGNOSTICS
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421
Mailing Address - Country:US
Mailing Address - Phone:617-252-6880
Mailing Address - Fax:617-252-6563
Practice Address - Street 1:640 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4853
Practice Address - Country:US
Practice Address - Phone:617-225-2526
Practice Address - Fax:617-252-6563
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52383174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3095410Medicaid
MA3095410Medicaid
F35750Medicare UPIN