Provider Demographics
NPI:1295496255
Name:ALL SEASONS ALLERGY AND ASTHMA MEDICAL CARE PC
Entity type:Organization
Organization Name:ALL SEASONS ALLERGY AND ASTHMA MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:VENKATESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SABHAE GANGADHARAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-869-2864
Mailing Address - Street 1:9851 QUEENS BLVD STE 1K
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4321
Mailing Address - Country:US
Mailing Address - Phone:718-275-4573
Mailing Address - Fax:
Practice Address - Street 1:9851 QUEENS BLVD STE 1K
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4321
Practice Address - Country:US
Practice Address - Phone:718-275-4573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-03
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3166841Medicaid