Healthcare Provider Details

I. General information

NPI: 1487812491
Provider Name (Legal Business Name): ADVANCED ALLERGY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 02/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8030 CROWDER BLVD
NEW ORLEANS LA
70127-1063
US

IV. Provider business mailing address

8030 CROWDER BLVD
NEW ORLEANS LA
70127-1063
US

V. Phone/Fax

Practice location:
  • Phone: 504-241-2220
  • Fax:
Mailing address:
  • Phone: 504-241-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number019973
License Number StateLA

VIII. Authorized Official

Name: DR. CHERYL HAYES WILLIAMS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 504-241-2220