Healthcare Provider Details
I. General information
NPI: 1326802927
Provider Name (Legal Business Name): ALLERGY & ASTHMA CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2024
Last Update Date: 02/13/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
108 JOHN ROBERT THOMAS DRIVE
EXTON PA
19341
US
IV. Provider business mailing address
108 JOHN ROBERT THOMAS DRIVE
EXTON PA
19341
US
V. Phone/Fax
- Phone: 610-363-0907
- Fax: 610-363-8097
- Phone: 610-363-0907
- Fax: 610-363-8097
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
MAHMOUD
K
EFFAT
Title or Position: PRESIDENT
Credential: M.D.
Phone: 610-363-0907