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General NPI Number Information
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NPI Number | 1104924901
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ALLERGY ASSOC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 154 EAST MAIN ST SUITE 203
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City | WESTBORO
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State | MA
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Zip | 01581
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Country | US
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Telephone | 508-366-4811
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Fax | 508-366-1216
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Provider Business Mailing Address
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Address Line | 154 EAST MAIN ST SUITE 203
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City | WESTBORO
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State | MA
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Zip | 01581
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Country | US
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Telephone | 508-366-4811
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Fax | 508-366-1216
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Authorized Official
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Title or Position | PHYSICIAN PRESIDENT
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Name | STANLEY R SAKOWITZ
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Credential | MD
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Telephone | 508-366-4811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | 29219
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License Number State | MA
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