NPIMap

Organization Active NPI

Advanced Allergy Inc

  • Allergy & Immunology Physician
  • Atlanta, GA
National Provider Identifier
1023352069
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
053937 Issued in GA
Legal business name
ADVANCED ALLERGY INC
Practice address
5512 Glenridge Dr NE
Unit a
Atlanta, GA 30342-7213
Phone
(404) 983-2034
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Maziar Rezvani, M.D.
Title
Owner
Phone
(404) 983-2034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X 053937 GA Primary

Addresses

Primary practice location

5512 Glenridge Dr NE
Unit a
Atlanta, GA 30342-7213

Mailing address

5512 Glenridge Dr NE
Unit a
Atlanta, GA 30342-7213
Phone (404) 983-2034

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1023352069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 GLENRIDGE DR NE",
            "address_2": "UNIT A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303427213",
            "telephone_number": "404-983-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 GLENRIDGE DR NE",
            "address_2": "UNIT A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303427213",
            "telephone_number": "404-983-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ALLERGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "REZVANI",
        "authorized_official_first_name": "MAZIAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-983-2034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "053937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.