Provider Demographics
NPI:1821277997
Name:ALLERGY, ASTHMA & SINUS CENTER, P.A.
Entity Type:Organization
Organization Name:ALLERGY, ASTHMA & SINUS CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GURDEV
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:JUDGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-859-5966
Mailing Address - Street 1:401 KEISLER DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7084
Mailing Address - Country:US
Mailing Address - Phone:919-859-5966
Mailing Address - Fax:
Practice Address - Street 1:401 KEISLER DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7084
Practice Address - Country:US
Practice Address - Phone:919-859-5966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35935207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCDA3587OtherRAIL ROAD MEDICARE
NC8947638Medicaid
NCE96350Medicare UPIN
NC8947638Medicaid