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NPI Code Detail

MEDICARE: TAK MEDICAL GROUP, PC

MEDICARE: TAK MEDICAL GROUP, 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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1700293396
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAK MEDICAL GROUP, PC
Provider Business Mailing Address
First Line : 48 NELSON ST
Second Line :
City : LEOMINSTER
State : MA
Zip : 01453-2134
Country : US
Telephone Number : 978-728-4455
Fax Number : 978-751-8546
Provider Business Practice Location Address
First Line : 47 ASHBY STATE RD
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-2038
Country : US
Telephone Number : 978-345-0303
Fax Number : 978-345-3529
Authorized Official
Title or Position : PRESIDENT - OWNER
Name : DR. PAYAM AGHASSI
Credential : M.D.
Telephone Number : 978-728-4455
Provider Enumeration Date : 07/16/2014
Last Update Date : 11/19/2015

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