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General NPI Number Information
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NPI Number | 1376828814
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Entity Type | Organization
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Legal Business Name | CLASSICAL ALLERGY CONSULTANTS PC
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Dates
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Enumeration Date | 10/17/2011
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Last Update Date | 12/28/2011
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Provider Practice Location Address
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Address Line | 701 SHARON RD
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City | BEAVER
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State | PA
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Zip | 15009-3147
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Country | US
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Telephone | 724-775-4099
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Fax | 724-775-3510
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Provider Business Mailing Address
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Address Line | 701 SHARON RD
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City | BEAVER
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State | PA
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Zip | 15009-3147
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Country | US
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Telephone | 724-775-4099
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Fax | 724-775-3510
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Authorized Official
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Title or Position | PRESIDENT
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Name | KATHYRN KRAUS
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Credential | MD
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Telephone | 724-775-4099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | MD021753E
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License Number State | PA
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