Basic Information
| Provider Information | |||||||||
| NPI: | 1801127469 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHESTNUT HILL ALLERGY AND ASTHMA ASSOCIATES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8200 FLOURTOWN AVE STE 4 | ||||||||
| Address2: | |||||||||
| City: | WYNDMOOR | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190387969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152472292 | ||||||||
| FaxNumber: | 2152476885 | ||||||||
| Practice Location | |||||||||
| Address1: | 8200 FLOURTOWN AVE STE 4 | ||||||||
| Address2: | |||||||||
| City: | WYNDMOOR | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152472292 | ||||||||
| FaxNumber: | 2153476885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2010 | ||||||||
| LastUpdateDate: | 03/23/2022 | ||||||||
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| AuthorizedOfficialLastName: | SEGAL | ||||||||
| AuthorizedOfficialFirstName: | MANAV | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2152472292 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RA0201X | MD426362 | PA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Allergy & Immunology |
No ID Information.