Provider Demographics
NPI:1619569027
Name:THE ALLERGY SUITE
Entity Type:Organization
Organization Name:THE ALLERGY SUITE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELISA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-558-0045
Mailing Address - Street 1:1633 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2042
Mailing Address - Country:US
Mailing Address - Phone:248-346-2945
Mailing Address - Fax:
Practice Address - Street 1:39595 W 10 MILE RD STE 111
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2948
Practice Address - Country:US
Practice Address - Phone:248-558-0045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-07
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty