Provider Demographics
NPI:1679533871
Name:ASKA, ALIDA GINA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIDA
Middle Name:GINA
Last Name:ASKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:942 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-2314
Mailing Address - Country:US
Mailing Address - Phone:617-325-0520
Mailing Address - Fax:617-325-9047
Practice Address - Street 1:942 SOUTH ST
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-2314
Practice Address - Country:US
Practice Address - Phone:617-325-0520
Practice Address - Fax:617-325-9047
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA52185207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ03903OtherBLUE CROSS/ BLUE SHIELD
MA6186639Medicaid
MA11578OtherHARVARD PILGRIM ID
MA52185OtherSTATE LICENSE
MAAA2615586OtherFED DEA NUMBER
MA52185OtherSTATE LICENSE
MA6186639Medicaid