Provider Demographics
NPI:1720271869
Name:ASTHMA AND ALLERGY CENTER LTD.
Entity Type:Organization
Organization Name:ASTHMA AND ALLERGY CENTER LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASIF
Authorized Official - Middle Name:IQBAL
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-796-5207
Mailing Address - Street 1:3040 BELMONT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1836
Mailing Address - Country:US
Mailing Address - Phone:330-759-3415
Mailing Address - Fax:330-759-9215
Practice Address - Street 1:3040 BELMONT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1836
Practice Address - Country:US
Practice Address - Phone:330-759-3415
Practice Address - Fax:330-759-9215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH90106207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2767475Medicaid
OHH80444Medicare UPIN
OH2767475Medicaid