Provider Demographics
NPI:1285326611
Name:FAMILY CENTER FOR ALLERGY AND ASTHMA LLC
Entity type:Organization
Organization Name:FAMILY CENTER FOR ALLERGY AND ASTHMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAPUL-HIDALGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-243-6115
Mailing Address - Street 1:PO BOX 34066
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20827-0066
Mailing Address - Country:US
Mailing Address - Phone:240-243-6115
Mailing Address - Fax:
Practice Address - Street 1:15200 SHADY GROVE RD STE 400
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6256
Practice Address - Country:US
Practice Address - Phone:240-243-6115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty