Provider Demographics
NPI:1740300532
Name:ALLERGY DIAGNOSTIC SYSTEMS INC
Entity type:Organization
Organization Name:ALLERGY DIAGNOSTIC SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLIGATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-831-6577
Mailing Address - Street 1:24400 HIGHPOINT RD STE 1
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6027
Mailing Address - Country:US
Mailing Address - Phone:216-831-6577
Mailing Address - Fax:216-831-6833
Practice Address - Street 1:24400 HIGHPOINT RD STE 1
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6027
Practice Address - Country:US
Practice Address - Phone:216-831-6577
Practice Address - Fax:216-831-6833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBA9296271Medicare ID - Type UnspecifiedGROUP NUMBER
OHBA9296272Medicare ID - Type UnspecifiedGROUP NUMBER
OHBA9296275Medicare ID - Type UnspecifiedGROUP NUMBER
OHBA9296273Medicare ID - Type UnspecifiedGROUP NUMBER
OHBA9296276Medicare ID - Type UnspecifiedGROUP NUMBER
OHBA9296274Medicare ID - Type UnspecifiedGROUP NUMBER