Provider Demographics
NPI:1326022880
Name:ALLERGY AND ASTHMA SPECIALISTS, LTD.
Entity Type:Organization
Organization Name:ALLERGY AND ASTHMA SPECIALISTS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:S
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-481-4383
Mailing Address - Street 1:1704 SIR WILLIAM OSLER DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3003
Mailing Address - Country:US
Mailing Address - Phone:757-481-4383
Mailing Address - Fax:757-481-4611
Practice Address - Street 1:1704 SIR WILLIAM OSLER DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3003
Practice Address - Country:US
Practice Address - Phone:757-481-4383
Practice Address - Fax:757-481-4611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC01592Medicare PIN
VACF1969Medicare PIN
VACN5602Medicare PIN
VAC00003Medicare PIN
VAC01591Medicare PIN