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General NPI Number Information
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NPI Number | 1376845453
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Entity Type | Organization
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Legal Business Name | ADVANCED ALLERGY & ASTHMA ASSESSMENT & DIAGNOSTIC, P.C.
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Dates
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Enumeration Date | 11/23/2010
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | 202-28 45TH AVENUE
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City | BAYSIDE
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State | NY
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Zip | 11361-2540
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Country | US
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Telephone | 718-224-7600
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Fax | 718-224-0593
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Provider Business Mailing Address
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Address Line | 202-28 45TH AVENUE
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City | BAYSIDE
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State | NY
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Zip | 11361-2540
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Country | US
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Telephone | 718-224-7600
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Fax | 718-224-0593
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES A SHAPIRO
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Credential | MD
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Telephone | 718-224-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number | 187008
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 187008
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License Number State | NY
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