Healthcare Provider Details

I. General information

NPI: 1801402862
Provider Name (Legal Business Name): ALLERGY AND ASTHMA CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 ROCHESTER HILL ROAD
ROCHESTER NH
03867
US

IV. Provider business mailing address

161 ROCHESTER HILL ROAD
ROCHESTER NH
03867
US

V. Phone/Fax

Practice location:
  • Phone: 603-332-7775
  • Fax: 603-332-7774
Mailing address:
  • Phone: 603-332-7775
  • Fax: 603-332-7774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHOK SHAH
Title or Position: OWNER, MD
Credential:
Phone: 603-332-7774