Provider Demographics
NPI:1649311051
Name:ALLERGYCARE PLLC
Entity type:Organization
Organization Name:ALLERGYCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:MR
Authorized Official - First Name:LUDWIG
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-624-7911
Mailing Address - Street 1:PO BOX 8086
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13505-8086
Mailing Address - Country:US
Mailing Address - Phone:315-624-7911
Mailing Address - Fax:315-624-7912
Practice Address - Street 1:2206 GENESEE ST
Practice Address - Street 2:STE 101
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5836
Practice Address - Country:US
Practice Address - Phone:315-624-7911
Practice Address - Fax:315-624-7912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241599-1207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY241599-1OtherSTATE LICENSE NUMBER
NY241599-1OtherSTATE LICENSE NUMBER