Provider Demographics
NPI:1851444814
Name:KALIL, ALLISON (PA-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:KALIL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 TARRYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2713
Mailing Address - Country:US
Mailing Address - Phone:603-627-1102
Mailing Address - Fax:603-647-5524
Practice Address - Street 1:184 TARRYTOWN RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2713
Practice Address - Country:US
Practice Address - Phone:603-627-1102
Practice Address - Fax:603-647-5524
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2232363AS0400X
NH0810363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical