Healthcare Provider Details

I. General information

NPI: 1497938278
Provider Name (Legal Business Name): WARWICK ALLERGY, P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 FORESTER AVE
WARWICK NY
10990-1126
US

IV. Provider business mailing address

PO BOX 309
WARWICK NY
10990
US

V. Phone/Fax

Practice location:
  • Phone: 845-986-5352
  • Fax: 845-986-6341
Mailing address:
  • Phone: 845-986-5352
  • Fax: 845-986-6341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number131379
License Number StateNY

VIII. Authorized Official

Name: BETH G LOUIE
Title or Position: PRESIDENT
Credential: MD
Phone: 845-986-6341