1639263080 NPI number — ALLERGY & ASTHMA TREATMENT SPECIALISTS, P.C.

Table of content: (NPI 1639263080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639263080 NPI number — ALLERGY & ASTHMA TREATMENT SPECIALISTS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLERGY & ASTHMA TREATMENT SPECIALISTS, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639263080
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
475 FRANKLIN STREET
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
FRAMINGHAM
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01702
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-879-2712
Provider Business Mailing Address Fax Number:
508-879-0637

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
475 FRANKLIN STREET
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
FRAMINGHAM
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-879-2712
Provider Business Practice Location Address Fax Number:
508-879-0637
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RHEIN
Authorized Official First Name:
STUART
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
508-879-2712

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  35301 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2000000109 . This is a "PILGRIM HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2046563 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 705301 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: K08312 . This is a "BLUE CROSS-BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0200021 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: B20228001 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2023725 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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