Ali Anwar Aboalela
Individual provider Active NPI Oral and Maxillofacial Pathology Dentistry · Boston, MA
NPI 1356773642 · NPPES record last updated Aug 8, 2013
Key facts
- NPI
- 1356773642
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Pathology Dentistry 1223P0106X
- License
- DL11825 (MA)
- Practice address
- 75 Francis Street
Brigham and Womens Hospital
Boston, MA 02115 - Phone
- (617) 732-6974
- NPI assigned
- Aug 8, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DL11825 | MA | MD | Oral and Maxillofacial Pathology Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | DL11825 | MA | Yes |
Addresses
Primary practice location
75 Francis Street
Brigham and Womens Hospital
Boston, MA 02115
Mailing address
151 Tremont St
Apt 17B
Boston, MA 02111-1125
Phone (617) 515-9993
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All providers in Boston, MA · Oral and Maxillofacial Pathology Dentistry in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.