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Organization

BACK BAY ALLERGY ASSOCIATES LLC

Active
Parent organization
BACK BAY ALLERGY ASSOCIATES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
BACK BAY ALLERGY ASSOCIATES LLC
Authorized official
DR. MARTIN GEORGE OSTRO M.D. (OWNER/MANAGER)
(978) 452-4626
Entity
Organization

Contact information

Practice address
77 E MERRIMACK ST, SUITE 6, LOWELL, MA 01852-1251
(978) 452-4626
(707) 598-0684
Mailing address
77 E MERRIMACK ST, SUITE 6, LOWELL, MA 01852-1251
(978) 452-4626
(707) 598-0684

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
42186
MA

Other

Enumeration date
10/23/2015
Last updated
10/23/2015
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