=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497934350
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLERGY AND ASTHMA ASSOCIATES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2007
-----------------------------------------------------
Last Update Date | 02/28/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 BALD HILL RD SUITE 527
-----------------------------------------------------
City | WARWICK
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02886-1617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-739-5901
-----------------------------------------------------
Fax | 401-739-8170
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400 BALD HILL RD SUITE 527
-----------------------------------------------------
City | WARWICK
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02886-1617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 401-739-5901
-----------------------------------------------------
Fax | 401-739-8170
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | DR. DAVID ROBERT KATZEN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 401-739-5901
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207KA0200X
-----------------------------------------------------
Taxonomy Name | Allergy Physician
-----------------------------------------------------
License Number | MD06041
-----------------------------------------------------
License Number State | RI
-----------------------------------------------------