1851630891 NPI number — SUBURBAN ALLERGY CONSULTANTS LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851630891 NPI number — SUBURBAN ALLERGY CONSULTANTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUBURBAN ALLERGY CONSULTANTS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851630891
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1065 ANDREW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST CHESTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19380-4370
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
844-270-8485
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
822 MONTGOMERY AVE STE 318
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NARBERTH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19072-1948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-270-8584
Provider Business Practice Location Address Fax Number:
484-270-8584
Provider Enumeration Date:
02/12/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BOWSER
Authorized Official First Name:
CORINNA
Authorized Official Middle Name:
SABINE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
484-270-8584

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X , with the licence number:  MD428476 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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