Provider Demographics
NPI:1679734545
Name:MASS LUNG & ALLERGY, PC.
Entity Type:Organization
Organization Name:MASS LUNG & ALLERGY, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHASSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-466-4549
Mailing Address - Street 1:PO BOX 726
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-0726
Mailing Address - Country:US
Mailing Address - Phone:978-466-2692
Mailing Address - Fax:978-466-4754
Practice Address - Street 1:100 HOSPITAL RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2253
Practice Address - Country:US
Practice Address - Phone:978-466-2692
Practice Address - Fax:978-466-4754
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASS LUNG & ALLERGY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-23
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207KA0200X, 207RC0200X, 207RP1001X, 261QS1200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty