Provider Demographics
NPI:1598941122
Name:TRIANGLE ALLERGY & ASTHMA P A
Entity Type:Organization
Organization Name:TRIANGLE ALLERGY & ASTHMA P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PADMAJA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:GAYAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-851-2223
Mailing Address - Street 1:135 PARKWAY OFFICE CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7424
Mailing Address - Country:US
Mailing Address - Phone:919-851-2223
Mailing Address - Fax:919-851-2291
Practice Address - Street 1:135 PARKWAY OFFICE CT
Practice Address - Street 2:SUITE 100
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7424
Practice Address - Country:US
Practice Address - Phone:919-851-2223
Practice Address - Fax:919-851-2291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701365174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2329048Medicare PIN