Provider Demographics
NPI:1508863473
Name:ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:SHU
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MLS
Authorized Official - Phone:412-372-7131
Mailing Address - Street 1:4099 WILLIAM PENN HWY
Mailing Address - Street 2:STE 805
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2518
Mailing Address - Country:US
Mailing Address - Phone:412-372-7131
Mailing Address - Fax:412-372-0149
Practice Address - Street 1:4099 WILLIAM PENN HWY
Practice Address - Street 2:STE 805
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2518
Practice Address - Country:US
Practice Address - Phone:412-372-7131
Practice Address - Fax:412-372-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
101431OtherUPMC
790905OtherHIGHMARK BCBS
PA100764813-0002Medicaid
790905OtherHIGHMARK BCBS