Organization
NEW YORK ALLERGY ASTHMA & IMMUNOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAD AVSHALOMOV M.D. (PRESIDENT)
(718) 444-8014
Entity
Organization
Contact information
Practice address
2084 E 67TH ST, BROOKLYN, NY 11234-6008
(718) 444-8014
(718) 444-8068
Mailing address
PO BOX 541, OCEANSIDE, NY 11572-0541
(718) 444-8014
(718) 444-8068
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
174400000X
Specialist
—
—
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02217114
—
NY
Enumeration date
05/11/2017
Last updated
04/30/2018
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