Healthcare Provider Details

I. General information

NPI: 1316979974
Provider Name (Legal Business Name): ALLERGY GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N CURTIS RD STE 303
BOISE ID
83706
US

IV. Provider business mailing address

1000 N CURTIS RD STE 303
BOISE ID
83706
US

V. Phone/Fax

Practice location:
  • Phone: 208-377-4000
  • Fax: 208-375-8426
Mailing address:
  • Phone: 208-377-4000
  • Fax: 208-375-8426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: NEETU TALREJA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 208-377-4000