Healthcare Provider Details

I. General information

NPI: 1992970370
Provider Name (Legal Business Name): ALLERGY AND ASTHMA CLINIC OF EAST LANSING, PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 ASHER CT STE 200
EAST LANSING MI
48823-8444
US

IV. Provider business mailing address

612 W LAKE LANSING RD 100
EAST LANSING MI
48823-8528
US

V. Phone/Fax

Practice location:
  • Phone: 517-324-7020
  • Fax: 517-324-7021
Mailing address:
  • Phone: 517-324-7020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number4301080350
License Number StateMI

VIII. Authorized Official

Name: DR. VASIF CUNEYT KALFA
Title or Position: OWNER
Credential: M.D.
Phone: 517-324-7020