Provider Demographics
NPI:1619940046
Name:SMOLINSKI, ALAN MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MARK
Last Name:SMOLINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 LOVELL RD
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1223
Mailing Address - Country:US
Mailing Address - Phone:617-924-2432
Mailing Address - Fax:
Practice Address - Street 1:1 HARBORSIDE DR
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-2907
Practice Address - Country:US
Practice Address - Phone:617-568-6502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55485208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice