Provider Demographics
NPI:1558401588
Name:DEMARIA, ALFRED PAUL JR (MD)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:PAUL
Last Name:DEMARIA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALFRED
Other - Middle Name:
Other - Last Name:DEMARIA
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:305 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3515
Mailing Address - Country:US
Mailing Address - Phone:617-983-6550
Mailing Address - Fax:617-983-6925
Practice Address - Street 1:305 SOUTH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3515
Practice Address - Country:US
Practice Address - Phone:617-983-6550
Practice Address - Fax:617-983-6925
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA41088207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease