=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619731494
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. JEANNE LOMAS ALLERGY MEDICINE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2024
-----------------------------------------------------
Last Update Date | 02/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 CORPORATE PKWY STE 100
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14226-1263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-631-0380
-----------------------------------------------------
Fax | 716-836-0073
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 500 CORPORATE PKWY STE 100
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14226-1263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-631-0380
-----------------------------------------------------
Fax | 716-836-0073
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE MANAGER
-----------------------------------------------------
Name | EMILY N MORTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 716-631-0380
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2080P0201X
-----------------------------------------------------
Taxonomy Name | Pediatric Allergy/Immunology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207KA0200X
-----------------------------------------------------
Taxonomy Name | Allergy Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------