Provider Demographics
NPI:1851630891
Name:SUBURBAN ALLERGY CONSULTANTS LLC
Entity Type:Organization
Organization Name:SUBURBAN ALLERGY CONSULTANTS LLC
Other - Org Name:NARBERTH ALLERGY AND ASTHMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORINNA
Authorized Official - Middle Name:SABINE
Authorized Official - Last Name:BOWSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:484-270-8584
Mailing Address - Street 1:1065 ANDREW DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4370
Mailing Address - Country:US
Mailing Address - Phone:844-270-8485
Mailing Address - Fax:
Practice Address - Street 1:822 MONTGOMERY AVE STE 318
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1948
Practice Address - Country:US
Practice Address - Phone:484-270-8584
Practice Address - Fax:484-270-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428476207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty