Provider Demographics
NPI:1871834457
Name:THE ALLERGY & ASTHMA WELLNESS PRACTICE LLC
Entity Type:Organization
Organization Name:THE ALLERGY & ASTHMA WELLNESS PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-228-2312
Mailing Address - Street 1:200 E 16TH ST APT 12G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3711
Mailing Address - Country:US
Mailing Address - Phone:212-979-4572
Mailing Address - Fax:
Practice Address - Street 1:205 E 22ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4632
Practice Address - Country:US
Practice Address - Phone:212-228-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-07
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245245174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty