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NPI 1770504169 · Allergy & Immunology (Internal Medicine) Physician · Ozone Park, NY
Provider details
- NPI number
- 1770504169
- Entity type
- Individual
- Primary specialty
- Allergy & Immunology (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- Yes
- License
- 127088 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
9120 Atlantic Avenue
Ozone Park, NY 11416
Phone: (718) 641-8207
Approximate (ZIP-level) locationGet directions
Mailing address
89-06 135th Street
Jamaica, NY 11418
Registry dates
- Enumerated
- 2006-07-21
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.