Provider Demographics
NPI:1821245705
Name:QUEENS ALLERGY & ASTHMA CARE PLLC
Entity Type:Organization
Organization Name:QUEENS ALLERGY & ASTHMA CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:BELINDA
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-261-2661
Mailing Address - Street 1:10915 QUEENS BLVD
Mailing Address - Street 2:SUITE 1P
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5482
Mailing Address - Country:US
Mailing Address - Phone:718-261-2661
Mailing Address - Fax:718-261-0085
Practice Address - Street 1:10915 QUEENS BLVD
Practice Address - Street 2:SUITE 1P
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5482
Practice Address - Country:US
Practice Address - Phone:718-261-2661
Practice Address - Fax:718-261-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223927207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty