Provider Demographics
NPI:1235304528
Name:ASTHMA & ALLERGY SPECIALISTS, PC
Entity Type:Organization
Organization Name:ASTHMA & ALLERGY SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VANDANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRISHNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MS, FAAAAI,
Authorized Official - Phone:781-729-2293
Mailing Address - Street 1:115 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890
Mailing Address - Country:US
Mailing Address - Phone:781-729-2293
Mailing Address - Fax:
Practice Address - Street 1:955 MAIN ST, STE G-3
Practice Address - Street 2:SUITE G-3
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890
Practice Address - Country:US
Practice Address - Phone:781-729-2293
Practice Address - Fax:781-369-1493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203930261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
80761OtherFALLON COMMUNITY HEALTH P
M18757OtherBCBSMA
V35999OtherNETWORK HEALTH
602686OtherTUFTS HEALTHPLAN
DZ93OtherHARVARD PILGRIM HEALTHCAR
80761OtherFALLON COMMUNITY HEALTH P