Provider Demographics
NPI:1417054560
Name:THE ALLERGY AND ASTHMA TREATMENT CENTER
Entity Type:Organization
Organization Name:THE ALLERGY AND ASTHMA TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAAD
Authorized Official - Middle Name:AFIF
Authorized Official - Last Name:SANYURAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-334-6212
Mailing Address - Street 1:185 WADSWORTH RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-8330
Mailing Address - Country:US
Mailing Address - Phone:330-334-6212
Mailing Address - Fax:330-336-3913
Practice Address - Street 1:185 WADSWORTH RD
Practice Address - Street 2:SUITE H
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-8330
Practice Address - Country:US
Practice Address - Phone:330-334-6212
Practice Address - Fax:330-336-3913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35058482174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9248191Medicare PIN