Provider Demographics
NPI:1508606492
Name:OPPMAN, ALIVIA
Entity type:Individual
Prefix:
First Name:ALIVIA
Middle Name:
Last Name:OPPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 STRATHMORE RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-5203
Mailing Address - Country:US
Mailing Address - Phone:724-977-8989
Mailing Address - Fax:
Practice Address - Street 1:71 ALLEGHANY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02120-3338
Practice Address - Country:US
Practice Address - Phone:617-254-0954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program