Provider Demographics
NPI:1326198961
Name:ALLERGY & ASTHMA CONSULTANTS PC
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-729-0726
Mailing Address - Street 1:4104 VESTAL RD
Mailing Address - Street 2:STE 108
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-3554
Mailing Address - Country:US
Mailing Address - Phone:607-729-0726
Mailing Address - Fax:
Practice Address - Street 1:4104 VESTAL RD
Practice Address - Street 2:STE 108
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3554
Practice Address - Country:US
Practice Address - Phone:607-729-0726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186177207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03802OtherMVP
NYMD2000033OtherGHI PPO
NY28365OtherGHI HMO
NY01274928Medicaid
NY954180OtherAETNA HMO
NY10032322OtherCDPHP
NY4217085OtherAETNA NON HMO
NY10032322OtherCDPHP
NY01274928Medicaid