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Organization
BOSTON FOOD ALLERGY CENTER LLC
Active
Organization
BOSTON FOOD ALLERGY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN WHITE (CREDENTIALING MANAGER)
(502) 244-9859
Entity
Organization
Contact information
Practice address
65 HARRISON AVE STE 201, BOSTON, MA 02111-1924
(617) 636-8858
(617) 636-8826
Mailing address
1 NASSAU STREET UNIT 1906, BOSTON, MA 02111-1587
(617) 636-8858
(617) 804-6767
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
230907
MA
Other
Enumeration date
12/14/2015
Last updated
07/18/2022
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