Healthcare Provider Details

I. General information

NPI: 1477750552
Provider Name (Legal Business Name): NEW ENGLAND ALLERGY ASTHMA & IMMUNOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 TURNPIKE ST STE 31
NORTH ANDOVER MA
01845-5923
US

IV. Provider business mailing address

555 TURNPIKE ST STE 31
NORTH ANDOVER MA
01845-5923
US

V. Phone/Fax

Practice location:
  • Phone: 978-683-4299
  • Fax: 978-688-9603
Mailing address:
  • Phone: 978-683-4299
  • Fax: 978-688-9603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C1101X
TaxonomyCardiovascular-Interventional Technology Radiologic Technologist
License Number36670
License Number StateMA

VIII. Authorized Official

Name: DR. THOMAS F JOHNSON
Title or Position: OWNER
Credential: M.D.
Phone: 978-683-4299