# ALLERGY ASTHMA AND IMMUNOLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790816957
- **Authorized official:** MRS. ELENI LIVAS (MANAGER)
- **Authorized official phone:** (859) 277-3114

## Contact information

- **Practice address:** 1019 MAJESTIC DR STE 210, LEXINGTON, KY 40513-1947
- **Practice address phone:** (859) 277-3114
- **Practice address fax:** (859) 275-1942
- **Mailing address:** 1019 MAJESTIC DR STE 210, LEXINGTON, KY 40513-1947
- **Mailing address phone:** (859) 277-3114
- **Mailing address fax:** (859) 275-1942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7890399400 | — | KY |