Provider Demographics
NPI:1811162530
Name:ALIPHAS, AVNER (MD)
Entity type:Individual
Prefix:DR
First Name:AVNER
Middle Name:
Last Name:ALIPHAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON STREET
Mailing Address - Street 2:WHITE BLDG, STE 544
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1919
Mailing Address - Country:US
Mailing Address - Phone:617-910-0368
Mailing Address - Fax:888-806-8144
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:WHITE BLDG, SUITE 544
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-910-0368
Practice Address - Fax:888-806-8144
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229378207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA002183901Medicare PIN
MA0027916Medicare PIN