Provider Demographics
NPI:1265996102
Name:ALLERGY & IMMUNOLOGY SPECIALISTS, LLC
Entity type:Organization
Organization Name:ALLERGY & IMMUNOLOGY SPECIALISTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-512-4310
Mailing Address - Street 1:13575 W INDIAN SCHOOL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-4906
Mailing Address - Country:US
Mailing Address - Phone:623-512-4310
Mailing Address - Fax:623-321-6322
Practice Address - Street 1:13575 W INDIAN SCHOOL RD STE 200
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-4906
Practice Address - Country:US
Practice Address - Phone:623-512-4310
Practice Address - Fax:623-512-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ207K00000XOtherTAXONOMY CODE