Provider Demographics
NPI:1659492684
Name:RANDY S STOLOFF MD ADULT & PEDIATRIC ASTHMA & ALLERY PLLC
Entity Type:Organization
Organization Name:RANDY S STOLOFF MD ADULT & PEDIATRIC ASTHMA & ALLERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:STOLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-561-3377
Mailing Address - Street 1:106 WEST BAY PLAZA
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901
Mailing Address - Country:US
Mailing Address - Phone:518-561-3377
Mailing Address - Fax:518-563-7433
Practice Address - Street 1:106 WEST BAY PLAZA
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901
Practice Address - Country:US
Practice Address - Phone:518-561-3377
Practice Address - Fax:518-563-7433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5N8121OtherEMPIRE BCBS
NYBA0363Medicare ID - Type Unspecified