Provider Demographics
NPI:1043288293
Name:ALLERGY ASTHMA IMMUNOLOGY OF ROCHESTER, PC
Entity Type:Organization
Organization Name:ALLERGY ASTHMA IMMUNOLOGY OF ROCHESTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-442-0150
Mailing Address - Street 1:3136 WINTON RD S STE 203
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2928
Mailing Address - Country:US
Mailing Address - Phone:585-442-0150
Mailing Address - Fax:585-271-8704
Practice Address - Street 1:3136 WINTON RD S STE 203
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2928
Practice Address - Country:US
Practice Address - Phone:585-442-0150
Practice Address - Fax:585-271-8704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
17964AMedicare ID - Type Unspecified