Provider Demographics
NPI:1639678253
Name:ALISON RENEE GRECO
Entity type:Organization
Organization Name:ALISON RENEE GRECO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/HERBALIST
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC, MAOM
Authorized Official - Phone:617-829-4040
Mailing Address - Street 1:46 BOSTONIA AVE
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 NEWBURY ST STE 4
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3289
Practice Address - Country:US
Practice Address - Phone:617-829-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-09
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center