Provider Demographics
NPI:1598759839
Name:ALLERGY AND ASTHMA CARE CENTER PC
Entity Type:Organization
Organization Name:ALLERGY AND ASTHMA CARE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAFEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:DANESHVAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-931-2164
Mailing Address - Street 1:5001 SEMINARY RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1950
Mailing Address - Country:US
Mailing Address - Phone:703-931-2164
Mailing Address - Fax:703-931-2170
Practice Address - Street 1:5001 SEMINARY RD
Practice Address - Street 2:SUITE 116
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1950
Practice Address - Country:US
Practice Address - Phone:703-931-2164
Practice Address - Fax:703-931-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01148Medicare ID - Type Unspecified