Basic Information
| Provider Information | |||||||||
| NPI: | 1912970591 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KALIGIAN | ||||||||
| FirstName: | ARAM | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 771 ALBANY ST | ||||||||
| Address2: | DOWLING 5 SOUTH | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021182525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174144465 | ||||||||
| FaxNumber: | 6174143345 | ||||||||
| Practice Location | |||||||||
| Address1: | 632 BLUE HILL AVE | ||||||||
| Address2: | DEPT FAMILY MEDICINE | ||||||||
| City: | DORCHESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021213213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178253400 | ||||||||
| FaxNumber: | 6178257217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2006 | ||||||||
| LastUpdateDate: | 09/23/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 220466 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2040531 | 05 | MA | MEDICAID |