Healthcare Provider Details

I. General information

NPI: 1083982466
Provider Name (Legal Business Name): METROWEST ALLERGY ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2011
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 LINCOLN ST SUITE 208
FRAMINGHAM MA
01702-8264
US

IV. Provider business mailing address

61 LINCOLN ST SUITE 208
FRAMINGHAM MA
01702-8264
US

V. Phone/Fax

Practice location:
  • Phone: 508-628-5400
  • Fax: 508-628-5410
Mailing address:
  • Phone: 508-628-5400
  • Fax: 508-628-5410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIEL JOHN MUPPIDI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 508-628-5400