Back Bay Allergy Associates LLC
Organization Active NPI Specialist · Brookline, MA
NPI 1821151572 · NPPES record last updated Jul 15, 2015
Key facts
- NPI
- 1821151572
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 30946 (MA)
- Legal business name
- BACK BAY ALLERGY ASSOCIATES LLC
- Practice address
- 1101 Beacon St
Brookline, MA 02446-5587 - Phone
- (617) 734-2202
- Fax
- (617) 734-2408
- NPI assigned
- Dec 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Martin George Ostro, M.D.
- Title
- Manager
- Phone
- (617) 734-2202
Subparts reporting this organization as parent 1
Practitioners 1
-
Martin George Ostro, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160323000646 | MA | Part B Supplier - Clinic/Group Practice | 6204133069 |
Receives reassigned benefits from 1 practitioner Practice locations: Brookline, MA |
National Provider Directory
Locations
1101 Beacon St
Ste 7
Brookline, MA 02446
Phone (617) 278-6322
1101 Beacon St
Ste 7E
Brookline, MA 02446
Phone (617) 566-4099
1101 Beacon St
Fl 7
Brookline, MA 02446
1101 Beacon St
Ste 701E
Brookline, MA 02446
Phone (617) 734-2202
77 E Merrimack St
Ste 6
Lowell, MA 01852
Phone (978) 323-4441
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 30946 | MA | Yes |
Addresses
Primary practice location
1101 Beacon St
Brookline, MA 02446-5587
Mailing address
1101 Beacon St
Suite 7 East
Brookline, MA 02446-5587
Phone (617) 734-2202
Other providers in Brookline, MA
- Elvin Aydin Keles
- Khadijat Ayinla
- Haleh Azar
- Emily Bachmann
- Sharon Sara Bacigalupi
- Back on Track, P.C.
- Back on Track, P.C.
- George Badlissi
- Ali Bahadori
- Moogeh Baharnoori
All providers in Brookline, MA · Specialist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2015. 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.