MEDICARE: JACKSON HEIGHTS ALLERGY& ASTHMA PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician

General Provider Information

NPI Number	:	1427668318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACKSON HEIGHTS ALLERGY& ASTHMA PC

Provider Business Mailing Address
First Line	:	9317 ROOSEVELT AVE FL 2
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7943
Country	:	US
Telephone Number	:	718-899-9009
Fax Number	:	718-899-9002

Provider Business Practice Location Address
First Line	:	9317 ROOSEVELT AVE FL 2
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7943
Country	:	US
Telephone Number	:	718-899-9009
Fax Number	:	718-899-9002

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. STANLEY GOLDSTEIN
Credential	:	M.D
Telephone Number	:	718-899-9009

Provider Enumeration Date	:	08/05/2020
Last Update Date	:	02/10/2026

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