# BOSTON FOOD ALLERGY CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386019503
- **Authorized official:** SHAUN WHITE (CREDENTIALING MANAGER)
- **Authorized official phone:** (502) 244-9859

## Contact information

- **Practice address:** 65 HARRISON AVE STE 201, BOSTON, MA 02111-1924
- **Practice address phone:** (617) 636-8858
- **Practice address fax:** (617) 636-8826
- **Mailing address:** 1 NASSAU STREET UNIT 1906, BOSTON, MA 02111-1587
- **Mailing address phone:** (617) 636-8858
- **Mailing address fax:** (617) 804-6767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | 230907 | MA | Yes |

## Other

- **Enumeration date:** 12/14/2015
- **Last updated:** 07/18/2022