Provider Demographics
NPI:1518706308
Name:MCNISH, ALICIA (MBBS, DM DERMATALOGY)
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:
Last Name:MCNISH
Suffix:
Gender:F
Credentials:MBBS, DM DERMATALOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HEATHWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:ST. ANDREW
Mailing Address - Zip Code:00000
Mailing Address - Country:JM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 ALBANY ST
Practice Address - Street 2:8TH FLOOR, SUITE 8B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-638-7420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2025-01-30
Deactivation Date:2025-01-13
Deactivation Code:
Reactivation Date:2025-01-30
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program