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General NPI Number Information
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NPI Number | 1861593113
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Entity Type | Organization
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Legal Business Name | STATEN ISLAND ALLERGY OFFICE PC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11 RALPH PL SUITE 305
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City | STATEN ISLAND
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State | NY
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Zip | 10304-4419
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Country | US
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Telephone | 718-273-9111
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Fax | 718-448-2003
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Provider Business Mailing Address
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Address Line | 11 RALPH PL SUITE 305
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City | STATEN ISLAND
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State | NY
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Zip | 10304-4419
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Country | US
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Telephone | 718-273-9111
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Fax | 718-448-2003
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HARLAN R DAMAN
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Credential | MD
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Telephone | 718-273-9111
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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 | 101389
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License Number State | NY
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