Provider Demographics
NPI:1396383410
Name:COLUMBO ASTHMA ALLERGY & IMMUNOLOGY LLC
Entity Type:Organization
Organization Name:COLUMBO ASTHMA ALLERGY & IMMUNOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-527-2000
Mailing Address - Street 1:830 OLD LANCASTER RD STE 301
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3118
Mailing Address - Country:US
Mailing Address - Phone:610-527-2000
Mailing Address - Fax:
Practice Address - Street 1:830 OLD LANCASTER RD STE 301
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3118
Practice Address - Country:US
Practice Address - Phone:610-527-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-19
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty