Basic Information
| Provider Information | |||||||||
| NPI: | 1043288293 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLERGY ASTHMA IMMUNOLOGY OF ROCHESTER, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3136 WINTON RD S STE 203 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146232928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5854420150 | ||||||||
| FaxNumber: | 5852718704 | ||||||||
| Practice Location | |||||||||
| Address1: | 3136 WINTON RD S STE 203 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146232928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5854420150 | ||||||||
| FaxNumber: | 5852718704 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 07/20/2021 | ||||||||
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| AuthorizedOfficialLastName: | HARTEL | ||||||||
| AuthorizedOfficialFirstName: | ALBERT | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5854420150 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 07/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207K00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Allergy & Immunology |
No ID Information.