Provider Demographics
NPI:1891221834
Name:ALISONRD LLC
Entity Type:Organization
Organization Name:ALISONRD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAPLANES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN, CDE
Authorized Official - Phone:617-645-4819
Mailing Address - Street 1:3 ALLIED DR STE 303
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-6148
Mailing Address - Country:US
Mailing Address - Phone:617-645-4819
Mailing Address - Fax:781-207-7981
Practice Address - Street 1:3 ALLIED DR STE 303
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6148
Practice Address - Country:US
Practice Address - Phone:617-645-4819
Practice Address - Fax:781-207-7981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2003261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0378Medicare UPIN