Provider Demographics
NPI:1356555205
Name:ASTHMA AND LUNG CARE PLLC
Entity type:Organization
Organization Name:ASTHMA AND LUNG CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAHIN
Authorized Official - Middle Name:FIROZ
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-758-5864
Mailing Address - Street 1:90 MEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772
Mailing Address - Country:US
Mailing Address - Phone:631-758-5864
Mailing Address - Fax:631-654-2024
Practice Address - Street 1:90 MEDFORD AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1202
Practice Address - Country:US
Practice Address - Phone:631-758-5864
Practice Address - Fax:631-654-2024
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASTHMA AND LUNG CARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-10
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1665381207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100001659OtherMEDICARE
NY01275910Medicaid
NY18F311Medicare ID - Type Unspecified
NY01275910Medicaid