Provider Demographics
NPI:1588110381
Name:CHILDREN'S ASTHMA AND LUNG SPECIALISTS LLC
Entity type:Organization
Organization Name:CHILDREN'S ASTHMA AND LUNG SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC PULMONOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-608-5170
Mailing Address - Street 1:3086 ROUTE 27
Mailing Address - Street 2:SUITE 10
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1658
Mailing Address - Country:US
Mailing Address - Phone:844-543-5864
Mailing Address - Fax:844-314-1144
Practice Address - Street 1:3086 ROUTE 27
Practice Address - Street 2:SUITE 10
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1658
Practice Address - Country:US
Practice Address - Phone:844-543-5864
Practice Address - Fax:844-314-1144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA097748002080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Single Specialty