Provider Demographics
NPI:1073642708
Name:ALLERGY & ASTHMA CENTER OF MASSACHUSETTS, P.C.
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA CENTER OF MASSACHUSETTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:STEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-232-1690
Mailing Address - Street 1:25 BOYLSTON ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1715
Mailing Address - Country:US
Mailing Address - Phone:617-232-1690
Mailing Address - Fax:617-739-7082
Practice Address - Street 1:25 BOYLSTON ST
Practice Address - Street 2:SUITE 215
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1715
Practice Address - Country:US
Practice Address - Phone:617-232-1690
Practice Address - Fax:617-739-7082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60529207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9763180Medicaid
MAM17942OtherBCBS GROUP PROVIDER
MA601648OtherTUFTS GROUP PROVIDER
MAM21730Medicare PIN
M21730Medicare UPIN