Healthcare Provider Details
I. General information
NPI: 1265643522
Provider Name (Legal Business Name): THE NATIONAL ASTHMA & ALLERGY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/25/2007
Last Update Date: 01/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5722 7TH AVE
BROOKLYN NY
11220-3903
US
IV. Provider business mailing address
30 RIDINGS PKWY
PRINCETON NJ
08540-8639
US
V. Phone/Fax
- Phone: 718-439-5958
- Fax: 718-492-4931
- Phone: 732-422-3404
- Fax: 732-422-3404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207KA0200X |
| Taxonomy | Allergy Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
EMERALD
THAW
Title or Position: M.D
Credential:
Phone: 732-422-3404