Provider Demographics
NPI:1033359120
Name:BOSTON ALLERGY & ASTHMA CONSULTANTS PC
Entity Type:Organization
Organization Name:BOSTON ALLERGY & ASTHMA CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-636-5333
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-4200
Mailing Address - Country:US
Mailing Address - Phone:603-673-9411
Mailing Address - Fax:603-673-9899
Practice Address - Street 1:800 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1552
Practice Address - Country:US
Practice Address - Phone:617-636-5333
Practice Address - Fax:617-636-4843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1100826567AMedicaid
MA0010643Medicare PIN