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General NPI Number Information
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NPI Number | 1811103104
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Entity Type | Organization
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Legal Business Name | FAMILY ALLERGY AND ASTHMA CARE, PLLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 3771 NESCONSET HWY SUITE 105
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City | SOUTH SETAUKET
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State | NY
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Zip | 11720-1163
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Country | US
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Telephone | 631-751-4661
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Fax | 631-689-2148
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Provider Business Mailing Address
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Address Line | 3771 NESCONSET HWY SUITE 105
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City | SOUTH SETAUKET
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State | NY
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Zip | 11720-1163
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Country | US
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Telephone | 631-751-4661
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Fax | 631-689-2148
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. CRISTINA MARIA DAIAN
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Credential | M.D.
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Telephone | 631-751-4661
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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 | 214548
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License Number State | NY
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