Provider Demographics
NPI:1861536096
Name:ALLERGY & ASTHMA CLINIC, P.C.
Entity type:Organization
Organization Name:ALLERGY & ASTHMA CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAZNICKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-861-2049
Mailing Address - Street 1:16 CLARKE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4988
Mailing Address - Country:US
Mailing Address - Phone:781-861-2049
Mailing Address - Fax:781-861-1502
Practice Address - Street 1:16 CLARKE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4988
Practice Address - Country:US
Practice Address - Phone:781-861-2049
Practice Address - Fax:781-861-1502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18907OtherBCBS PRACTICE ID