Provider Demographics
NPI:1194715771
Name:ONEILL, ALISON MACLEOD (MD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:MACLEOD
Last Name:ONEILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3789
Mailing Address - Country:US
Mailing Address - Phone:617-995-3050
Mailing Address - Fax:617-995-3049
Practice Address - Street 1:840 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3789
Practice Address - Country:US
Practice Address - Phone:617-995-3050
Practice Address - Fax:617-995-3049
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2138812084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0169480Medicaid
MAJ24750OtherBCBS MA
MA213881OtherTUFTS HEALTH PLAN
G30840Medicare UPIN
MAA33767Medicare ID - Type Unspecified