Provider Demographics
NPI:1861593113
Name:STATEN ISLAND ALLERGY OFFICE PC
Entity type:Organization
Organization Name:STATEN ISLAND ALLERGY OFFICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARLAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-273-9111
Mailing Address - Street 1:11 RALPH PL
Mailing Address - Street 2:SUITE 305
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4419
Mailing Address - Country:US
Mailing Address - Phone:718-273-9111
Mailing Address - Fax:718-448-2003
Practice Address - Street 1:11 RALPH PL
Practice Address - Street 2:SUITE 305
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4419
Practice Address - Country:US
Practice Address - Phone:718-273-9111
Practice Address - Fax:718-448-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101389207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0098056OtherDR RUBINSTEIN CIGNA
NYP840367OtherDR DAMAN OXFORD
NY0003513OtherGHI GROUP #
NY4458477OtherDR RUBINSTEIN AETNA
NY0003513OtherDR DAMAN GHI GROUP #
NY2099873OtherDR DAMAN GHI INDIVIDUAL
NY578562OtherDR DAMAN BCBS
NYP3634599OtherDR RUBINSTEIN OXFORD
NY85Y261OtherDR. RUBINSTEIN BCBS
NY4C1007OtherDR DAMAN HEALTHNET
NY4458477OtherDR RUBINSTEIN AETNA
NY969663Medicare ID - Type UnspecifiedDR. RUBINSTEIN
NY0003513OtherGHI GROUP #
NYC12553Medicare UPIN