Professional Allergy Assoc

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

License

29219 Issued in MA

Legal business name

PROFESSIONAL ALLERGY ASSOC

Practice address

154 East Main St
Suite 203
Westboro, MA 01581

Phone

(508) 366-4811

Fax

(508) 366-1216

NPI assigned

Sep 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stanley R Sakowitz, MD

Title

Physician President

Phone

(508) 366-4811

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1104924901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 EAST MAIN ST",
            "address_2": "SUITE 203",
            "city": "WESTBORO",
            "state": "MA",
            "postal_code": "01581",
            "telephone_number": "508-366-4811",
            "fax_number": "508-366-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 EAST MAIN ST",
            "address_2": "SUITE 203",
            "city": "WESTBORO",
            "state": "MA",
            "postal_code": "01581",
            "telephone_number": "508-366-4811",
            "fax_number": "508-366-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ALLERGY ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SAKOWITZ",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN PRESIDENT",
        "authorized_official_telephone_number": "508-366-4811",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "MA",
            "license": "29219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9771484",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GR#",
            "identifier": "M15845",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah P Lebeaux, LICSW
• Nadene Deborah Moll, PSYD
• Anthony Gabor Moncton, DC
• Robin A Montague, LICSW
• Kiritkumar Patel, M.D.
• Martin John Proulx, COTA-L
• Susan D Roberts, LICSW
• Carol Victor Rothman, LICSW
• Jonathon Stuart Rothman, MD
• Carol Anne Santarpio, MA LMHC

• All providers in Westboro, MA
• Allergy Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.