Provider Demographics
NPI:1548672843
Name:WEXFORD ALLERGY ASTHMA & IMMUNOLOGY LLC
Entity type:Organization
Organization Name:WEXFORD ALLERGY ASTHMA & IMMUNOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCHOLNICOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-719-2441
Mailing Address - Street 1:100 BRADFORD RD
Mailing Address - Street 2:STE 410
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8486
Mailing Address - Country:US
Mailing Address - Phone:724-719-2441
Mailing Address - Fax:
Practice Address - Street 1:100 BRADFORD RD
Practice Address - Street 2:STE 410
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8486
Practice Address - Country:US
Practice Address - Phone:724-719-2441
Practice Address - Fax:724-719-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2080P0201X, 207KA0200X
PAMD428339207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/ImmunologyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty