Provider Demographics
NPI:1912050766
Name:ALLERGY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:ALLERGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-994-0120
Mailing Address - Street 1:49 STATE RD
Mailing Address - Street 2:WATUPPA BUILDING SUITE203
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-3322
Mailing Address - Country:US
Mailing Address - Phone:508-994-0120
Mailing Address - Fax:508-996-9636
Practice Address - Street 1:49 STATE RD
Practice Address - Street 2:WATUPPA BUILDING SUITE203
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3322
Practice Address - Country:US
Practice Address - Phone:508-994-0120
Practice Address - Fax:508-996-9636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9710736Medicaid
MAM10874Medicare ID - Type UnspecifiedMEDICARE NUMBER