OrganizationActive
Pediatric & Adult Allergy Asthma & Immunology Specialists, LLC
NPI 1790801512 · Allergy & Immunology Physician · Fort Wayne, IN
Provider details
- NPI number
- 1790801512
- Entity type
- Organization
- Primary specialty
- Allergy & Immunology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Monica Nelson, Business Manager(260) 422-5569
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3030 Lake Ave
Suite 27
Fort Wayne, IN 46805-5428
Phone: (260) 422-5569
Fax: (260) 422-6086
Approximate (ZIP-level) locationGet directions
Mailing address
3030 Lake Ave
Fort Wayne, IN 46805-5428
Registry dates
- Enumerated
- 2007-03-22
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.