Provider Demographics
NPI:1740393198
Name:ALLERGY, ASTHMA & PULMONARY ASSOCIATES, PA
Entity Type:Organization
Organization Name:ALLERGY, ASTHMA & PULMONARY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:SATTI
Authorized Official - Last Name:YASSIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:320-654-8266
Mailing Address - Street 1:1511 NORTHWAY DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1262
Mailing Address - Country:US
Mailing Address - Phone:320-654-8266
Mailing Address - Fax:320-654-8481
Practice Address - Street 1:1511 NORTHWAY DR STE 101
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1262
Practice Address - Country:US
Practice Address - Phone:320-654-8266
Practice Address - Fax:320-654-8481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC02683Medicare ID - Type Unspecified