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General NPI Number Information
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NPI Number | 1053365643
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Entity Type | Organization
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Legal Business Name | ALLERGY & CLINICAL IMMUNOLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 180 FORT COUCH RD SUITE 375
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City | PITTSBURGH
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State | PA
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Zip | 15241-1041
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Country | US
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Telephone | 412-833-8811
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Fax | 412-833-7011
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Provider Business Mailing Address
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Address Line | 180 FORT COUCH RD SUITE 375
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City | PITTSBURGH
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State | PA
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Zip | 15241-1041
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Country | US
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Telephone | 412-833-8811
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Fax | 412-833-7011
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MS. LISA M WHITE
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Credential |
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Telephone | 412-833-6768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | MD009759E
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License Number State | PA
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