Healthcare Provider Details

I. General information

NPI: 1184964785
Provider Name (Legal Business Name): VR ALLERGY AND ASTHMA CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2013
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E 60TH ST SUITE 4C
NEW YORK NY
10022-1117
US

IV. Provider business mailing address

4803 MARATHON PKWY
LITTLE NECK NY
11362-1256
US

V. Phone/Fax

Practice location:
  • Phone: 212-758-4633
  • Fax: 212-758-8015
Mailing address:
  • Phone: 917-992-2136
  • Fax: 212-758-8015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number264031
License Number StateNY

VIII. Authorized Official

Name: DR. VAHID RAHIMIAN
Title or Position: OWNER
Credential: D.O.
Phone: 917-992-2136