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General NPI Number Information
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NPI Number | 1093704298
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Entity Type | Individual
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Provider Name | PAYAM AGHASSI MD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 04/17/2012
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Provider Practice Location Address
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Address Line | 50 MEMORIAL DRIVE SUITE 113
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City | LEOMINSTER
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State | MA
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Zip | 01453-2238
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Country | US
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Telephone | 978-466-2692
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Fax | 978-466-4754
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Provider Business Mailing Address
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Address Line | PO BOX 726
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City | LEOMINSTER
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State | MA
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Zip | 01453
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Country | US
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Telephone | 978-466-2692
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Fax | 978-466-4754
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 216511
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | 216511
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 216511
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 216511
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | #216511
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License Number State | MA
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