Provider Demographics
NPI:1497934350
Name:ALLERGY AND ASTHMA ASSOCIATES, INC.
Entity Type:Organization
Organization Name:ALLERGY AND ASTHMA ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:KATZEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-739-5901
Mailing Address - Street 1:400 BALD HILL RD
Mailing Address - Street 2:SUITE 527
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1617
Mailing Address - Country:US
Mailing Address - Phone:401-739-5901
Mailing Address - Fax:401-739-8170
Practice Address - Street 1:400 BALD HILL RD
Practice Address - Street 2:SUITE 527
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1617
Practice Address - Country:US
Practice Address - Phone:401-739-5901
Practice Address - Fax:401-739-8170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD06041207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9000465Medicaid
RIC89692Medicare UPIN
RI9000465Medicaid