Provider Demographics
NPI:1760476592
Name:MARSHANSKY, ALLA V (MD)
Entity Type:Individual
Prefix:
First Name:ALLA
Middle Name:V
Last Name:MARSHANSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:690 CANTON ST
Mailing Address - Street 2:SUITE 325
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2321
Mailing Address - Country:US
Mailing Address - Phone:781-407-7713
Mailing Address - Fax:781-407-0998
Practice Address - Street 1:736 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-789-2777
Practice Address - Fax:617-254-6384
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2008-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA159130207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3208753Medicaid
H15403Medicare UPIN
MAA3103701Medicare PIN
MAHX5260Medicare PIN
MAA31037Medicare PIN