Healthcare Provider Details
I. General information
NPI: 1699107557
Provider Name (Legal Business Name): HEIGHTS ALLERGY AND IMMUNOLOGY LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/02/2013
Last Update Date: 08/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
129 WADSWORTH AVE SUITE 4
NEW YORK NY
10033-4828
US
IV. Provider business mailing address
PO BOX 1097
PARAMUS NJ
07653-1097
US
V. Phone/Fax
- Phone: 212-781-5889
- Fax: 212-781-6053
- Phone: 201-967-8425
- Fax: 201-263-4665
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 236320-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207KA0200X |
| Taxonomy | Allergy Physician |
| License Number | 236320-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
GOZEN
TUYSUZOGLU
Title or Position: M.D.
Credential: M.D.
Phone: 212-781-5889