Provider Demographics
NPI:1215340708
Name:ADVANCED ALLERGY & ASTHMA LLC
Entity type:Organization
Organization Name:ADVANCED ALLERGY & ASTHMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-224-5440
Mailing Address - Street 1:301 5TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TARENTUM
Mailing Address - State:PA
Mailing Address - Zip Code:15084-1861
Mailing Address - Country:US
Mailing Address - Phone:724-224-5440
Mailing Address - Fax:724-904-7634
Practice Address - Street 1:701 SHARON RD
Practice Address - Street 2:SUITE 3
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-3147
Practice Address - Country:US
Practice Address - Phone:724-775-4099
Practice Address - Fax:724-775-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty