Provider Demographics
NPI:1326305368
Name:MASS LUNG & ALLERGY, P.C.
Entity Type:Organization
Organization Name:MASS LUNG & ALLERGY, P.C.
Other - Org Name:SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHASSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-728-4641
Mailing Address - Street 1:50 MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453
Mailing Address - Country:US
Mailing Address - Phone:978-466-2692
Mailing Address - Fax:978-466-4754
Practice Address - Street 1:100 ERDMAN WAY
Practice Address - Street 2:SUITE 2S
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1804
Practice Address - Country:US
Practice Address - Phone:978-728-4641
Practice Address - Fax:978-728-1382
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASS LUNG & ALLERGY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic