Basic Information
| Provider Information | |||||||||
| NPI: | 1083795165 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FREED | ||||||||
| FirstName: | ALISA | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 LONGWATER DRIVE | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 143 LONGWATER DRIVE | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 01/16/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 230474 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | GIC/UNICARE | OTHER | 042297845 | 01 | UNITED HEALTH CARE | OTHER | 042297845 | 01 | TRICARE | OTHER | 3666503 | 01 | CIGNA | OTHER | 496345 | 01 | TUFTS AND TUFTS MEDICARE PREFERRED | OTHER | 7621961 | 01 | AETNA | OTHER | 042297845 | 01 | HCVM | OTHER | 1083795165 | 01 | NEIGHBORHOOD HEALTH PLAN | OTHER | 9334002 | 01 | NETWORK HEALTH | OTHER | AA316916 | 01 | HARVARD PILGRIM | OTHER | J41896 | 01 | MA | BCBSMA | OTHER | 1083795165 | 01 | MA | FALLON | OTHER | 1083795165 | 05 | MA | MEDICAID |