Northeastern Asthma & Allergy Associates, LLC
Organization Active NPI Pulmonary Disease Physician · Putnam, CT
NPI 1124228960 · NPPES record last updated Feb 20, 2014
Key facts
- NPI
- 1124228960
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- Legal business name
- NORTHEASTERN ASTHMA & ALLERGY ASSOCIATES, LLC
- Practice address
- 330 Pomfret St
Putnam, CT 06260-1854 - Phone
- (860) 928-5864
- Fax
- (860) 928-5865
- NPI assigned
- Jul 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. David Wasserstein, MD
- Title
- Physician
- Phone
- (860) 928-5864
Practitioners 6
-
Saima J Ansari, M.D.
-
Mohammed S Anwar, MD
-
Aubrey A Hepner, APRN
-
Milos Tomic, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070907000588 | CT | Part B Supplier - Clinic/Group Practice | 5698868537 |
Receives reassigned benefits from 6 practitioners Practice locations: Putnam, CT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 032853 | CT | |
| Allergy & Immunology Physician |
207K00000X | |||
| Pulmonary Disease Physician |
207RP1001X | Yes |
Addresses
Primary practice location
330 Pomfret St
Putnam, CT 06260-1854
Mailing address
330 Pomfret St
Putnam, CT 06260-1854
Phone (860) 928-5864
Other providers in Putnam, CT
- Victor Alexis Nieves
- Bonnie Lynn Niles
- Ilya Noginskiy
- Northeast Connecticut Dental Associates, Inc.
- Northeast Eyewear
- Northeastern Connecticut Cardiology Associates, PC
- Emma Rose Northridge
- Norwich Radiology Group, P.C.
- Savannah Lynn Nute
- Emmanuel J Nwabunor
All providers in Putnam, CT · Pulmonary Disease Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.