Provider Demographics
NPI:1457909269
Name:ALLERGY AND ASTHMA CLINIC, PC
Entity type:Organization
Organization Name:ALLERGY AND ASTHMA CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-343-1235
Mailing Address - Street 1:1117 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4703
Mailing Address - Country:US
Mailing Address - Phone:540-343-1235
Mailing Address - Fax:540-343-6337
Practice Address - Street 1:1117 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4703
Practice Address - Country:US
Practice Address - Phone:540-343-1235
Practice Address - Fax:540-343-6337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty