Basic Information
Provider Information
NPI: 1598723090
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALIPRANTIS
FirstName: ANTONIOS
MiddleName: O
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 111 CYPRESS ST
Address2:  
City: BROOKLINE
State: MA
PostalCode: 024456002
CountryCode: US
TelephoneNumber: 8573070896
FaxNumber:  
Practice Location
Address1: 850 BOYLSTON ST
Address2: STE 130
City: CHESTNUT HILL
State: MA
PostalCode: 024672477
CountryCode: US
TelephoneNumber: 6177329519
FaxNumber: 6177329577
Other Information
ProviderEnumerationDate: 05/03/2006
LastUpdateDate: 05/04/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500X217617MAY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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