Healthcare Provider Details

I. General information

NPI: 1497934350
Provider Name (Legal Business Name): ALLERGY AND ASTHMA ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 02/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BALD HILL RD SUITE 527
WARWICK RI
02886-1617
US

IV. Provider business mailing address

400 BALD HILL RD SUITE 527
WARWICK RI
02886-1617
US

V. Phone/Fax

Practice location:
  • Phone: 401-739-5901
  • Fax: 401-739-8170
Mailing address:
  • Phone: 401-739-5901
  • Fax: 401-739-8170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberMD06041
License Number StateRI

VIII. Authorized Official

Name: DR. DAVID ROBERT KATZEN
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 401-739-5901