Provider Demographics
NPI:1104932862
Name:MACALLISTER, EUNICE J (NP)
Entity type:Individual
Prefix:MS
First Name:EUNICE
Middle Name:J
Last Name:MACALLISTER
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:960 MASSACHUSETTS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:617-414-5951
Mailing Address - Fax:617-414-9201
Practice Address - Street 1:801 MASSACHUSETTS AVE STE 5A
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2605
Practice Address - Country:US
Practice Address - Phone:617-414-5951
Practice Address - Fax:617-414-9201
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2023-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN201666363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP1491Medicare PIN
S70174Medicare UPIN