MEDICARE: ALLERGY & ASTHMA PHYSICIANS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	698803	OTHER	MA	TUFTS GR#
2	V49144	OTHER	MA	NETWORK HEALTH
3	M13614	OTHER	MA	BCBS GR#

General Provider Information

NPI Number	:	1326030206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY & ASTHMA PHYSICIANS PC

Provider Business Mailing Address
First Line	:	3 WOODLAND RD STE 217
Second Line	:
City	:	STONEHAM
State	:	MA
Zip	:	02180-1711
Country	:	US
Telephone Number	:	781-395-2922
Fax Number	:	781-393-8905

Provider Business Practice Location Address
First Line	:	3 WOODLAND RD STE 217
Second Line	:
City	:	STONEHAM
State	:	MA
Zip	:	02180-1711
Country	:	US
Telephone Number	:	781-395-2922
Fax Number	:	781-393-8905

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JORDAN E SCOTT
Credential	:	MD
Telephone Number	:	781-395-2922

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	07/24/2020

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