Provider Demographics
NPI:1518029875
Name:A T TAMBOLI MD ALLERGY LAB
Entity Type:Organization
Organization Name:A T TAMBOLI MD ALLERGY LAB
Other - Org Name:A T TAMBOLI MD INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARDESHIR
Authorized Official - Middle Name:T
Authorized Official - Last Name:TAMBOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-997-2100
Mailing Address - Street 1:840 COLLIERS WAY
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062
Mailing Address - Country:US
Mailing Address - Phone:304-723-1810
Mailing Address - Fax:304-723-5741
Practice Address - Street 1:227 CANTON ROAD
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953
Practice Address - Country:US
Practice Address - Phone:740-266-2161
Practice Address - Fax:304-723-5741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty