Provider Demographics
NPI:1013912989
Name:DE ASIS, MA. LOURDES (MD)
Entity type:Individual
Prefix:
First Name:MA. LOURDES
Middle Name:
Last Name:DE ASIS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOODS ROAD
Mailing Address - Street 2:AMBULATORY CARE PAVILION, 3RD FLOOR
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-7518
Mailing Address - Fax:914-493-8130
Practice Address - Street 1:100 WOODS ROAD
Practice Address - Street 2:AMBULATORY CARE PAVILION, 3RD FLOOR
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-7518
Practice Address - Fax:914-493-8130
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203287207K00000X
NJ60591207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology