Provider Demographics
NPI:1477067999
Name:ASTHMA AND ALLERGY SPECIALISTS PC
Entity type:Organization
Organization Name:ASTHMA AND 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, FAAAI
Authorized Official - Phone:617-818-1490
Mailing Address - Street 1:115 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-3904
Mailing Address - Country:US
Mailing Address - Phone:617-818-5686
Mailing Address - Fax:781-369-1493
Practice Address - Street 1:955 MAIN ST STE 208
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-4302
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:2017-11-20
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203930207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty