Provider Demographics
NPI:1275583213
Name:HAAS, ANDREE ALISON (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREE
Middle Name:ALISON
Last Name:HAAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 ARSENAL ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2783
Mailing Address - Country:US
Mailing Address - Phone:617-923-8433
Mailing Address - Fax:617-923-8466
Practice Address - Street 1:311 ARSENAL ST
Practice Address - Street 2:SUITE 6
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2782
Practice Address - Country:US
Practice Address - Phone:617-923-8433
Practice Address - Fax:617-923-8466
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53035174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
J06509Medicare ID - Type Unspecified
MAB74879Medicare UPIN