Provider Demographics
NPI:1629029186
Name:PENNSYLVANIA ALLERGY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PENNSYLVANIA ALLERGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:RUDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-653-4900
Mailing Address - Street 1:330 CURRY HOLLOW RD
Mailing Address - Street 2:PENNSYLVANIA ALLERGY ASSOCIATES, INC.
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4621
Mailing Address - Country:US
Mailing Address - Phone:412-653-4900
Mailing Address - Fax:412-653-9969
Practice Address - Street 1:330 CURRY HOLLOW ROAD
Practice Address - Street 2:PENNSYLVANIA ALLERGY ASSOCIATES
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236
Practice Address - Country:US
Practice Address - Phone:412-653-4900
Practice Address - Fax:412-653-9969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1483520OtherHIGHMARK
PA104526Medicare ID - Type Unspecified