Provider Demographics
NPI:1407247075
Name:ALLERGY SINUS ASTHMA PRACTICE, LLC
Entity Type:Organization
Organization Name:ALLERGY SINUS ASTHMA PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKHILESH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUKSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-393-8888
Mailing Address - Street 1:1700 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6625
Mailing Address - Country:US
Mailing Address - Phone:330-393-8888
Mailing Address - Fax:330-393-7777
Practice Address - Street 1:1700 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6625
Practice Address - Country:US
Practice Address - Phone:330-393-8888
Practice Address - Fax:330-393-7777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081725207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty