Provider Demographics
NPI:1619967346
Name:FRIEDMANN, ALISON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:
Last Name:FRIEDMANN
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: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:617-726-2737
Mailing Address - Fax:617-724-0702
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAW 8-B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-3315
Practice Address - Fax:617-724-8526
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA157254208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3179362Medicaid
MAJ18879OtherBCBS MA
MA157254OtherTUFTS HEALTH PLAN
MA157254OtherTUFTS HEALTH PLAN
MAA23578Medicare ID - Type Unspecified