Basic Information
| Provider Information | |||||||||
| NPI: | 1750917621 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOULET-SCOTT | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | SCOTT | ||||||||
| OtherFirstName: | ALLISON | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | ONE BOSTON MEDICAL CENTER PLACE | ||||||||
| Address2: | BCD BUILDING-1ST FLOOR- ROOM 1004 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174144929 | ||||||||
| FaxNumber: | 6174147759 | ||||||||
| Practice Location | |||||||||
| Address1: | ONE BOSTON MEDICAL CENTER PLACE | ||||||||
| Address2: | BCD BUILDING-1ST FLOOR- ROOM 1004 | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174144929 | ||||||||
| FaxNumber: | 6174147759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2020 | ||||||||
| LastUpdateDate: | 03/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.