Basic Information
| Provider Information | |||||||||
| NPI: | 1316979974 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLERGY GROUP PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 N CURTIS RD | ||||||||
| Address2: | STE 303 | ||||||||
| City: | BOISE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 83706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083774000 | ||||||||
| FaxNumber: | 2083758426 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 N CURTIS RD | ||||||||
| Address2: | STE 303 | ||||||||
| City: | BOISE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 83706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083774000 | ||||||||
| FaxNumber: | 2083758426 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 08/17/2020 | ||||||||
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| AuthorizedOfficialLastName: | TALREJA | ||||||||
| AuthorizedOfficialFirstName: | NEETU | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2083774000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 08/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207K00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Allergy & Immunology |
No ID Information.