Individual
PAYAM AGHASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 MEMORIAL DRIVE, SUITE 113, LEOMINSTER, MA 01453-2238
(978) 466-2692
(978) 466-4754
Mailing address
PO BOX 726, LEOMINSTER, MA 01453
(978) 466-2692
(978) 466-4754
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
216511
MA
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
216511
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
216511
MA
207RP1001X
Pulmonary Disease Physician
Primary
216511
MA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
#216511
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2121247
—
MA
01
—
467556
TUFTS
—
01
—
9771476
GROUP MEDICAID
—
01
—
AA66577
HARVARD PILGRIM
—
01
—
J27245
BLUE CROSS IF MASS
—
01
—
M20928
GROUP MEDICARE
—
Enumeration date
10/19/2005
Last updated
04/17/2012
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