Healthcare Provider Details

I. General information

NPI: 1689974339
Provider Name (Legal Business Name): ALLERGY & ASTHMA HEALTH ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 10/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 S QUEEN ST
YORK PA
17403-4637
US

IV. Provider business mailing address

1620 S QUEEN ST
YORK PA
17403-4637
US

V. Phone/Fax

Practice location:
  • Phone: 717-843-6663
  • Fax:
Mailing address:
  • Phone: 717-843-6663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD043413L
License Number StatePA

VIII. Authorized Official

Name: WILLIAM P LAVIETES
Title or Position: PRESIDENT
Credential: MD
Phone: 717-843-6663