Provider Demographics
NPI:1780871970
Name:TOOSSI, ALIREZA (MD)
Entity type:Individual
Prefix:DR
First Name:ALIREZA
Middle Name:
Last Name:TOOSSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:22 LIBERTY DR 6F
Mailing Address - Street 2:SUITE 6F
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02210
Mailing Address - Country:US
Mailing Address - Phone:617-244-1669
Mailing Address - Fax:617-244-6769
Practice Address - Street 1:22 LIBERTY DR
Practice Address - Street 2:SUITE 6F
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02210
Practice Address - Country:US
Practice Address - Phone:617-244-1669
Practice Address - Fax:617-244-6769
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ37478207R00000X
MA234084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110081675AMedicaid
AZ272389-01Medicaid
AZ272389-01Medicaid