Provider Demographics
NPI:1174794556
Name:ZALIECKAS, JILL M (MD)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:ZALIECKAS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:FEGAN 3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-1838
Mailing Address - Fax:617-730-0477
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:FEGAN 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-1838
Practice Address - Fax:617-730-0477
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2021-10-28
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Provider Licenses
StateLicense IDTaxonomies
MA2491912086S0120X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery