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General NPI Number Information
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NPI Number | 1427318062
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Entity Type | Organization
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Legal Business Name | FAMILY ALLERGY ASTHMA & SINUS CARE, P.A.
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 10370 PARK RD SUITE 202
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City | CHARLOTTE
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State | NC
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Zip | 28210-8508
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Country | US
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Telephone | 704-817-2022
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Fax | 704-817-2024
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Provider Business Mailing Address
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Address Line | 10370 PARK RD SUITE 202
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City | CHARLOTTE
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State | NC
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Zip | 28210-8508
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Country | US
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Telephone | 704-817-2022
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Fax | 704-817-2024
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANJAY J KHIANI
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Credential | MD
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Telephone | 704-817-2022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 2012-00056
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License Number State | NC
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