1578628889 NPI number — ASTHMA & ALLERGY SOLUTIONS, INC.

Table of content: (NPI 1578628889)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578628889 NPI number — ASTHMA & ALLERGY SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASTHMA & ALLERGY SOLUTIONS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578628889
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
858 S WHITE HORSE PIKE
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
HAMMONTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08037-2031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-567-6520
Provider Business Mailing Address Fax Number:
609-567-6524

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
858 S WHITE HORSE PIKE
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
HAMMONTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08037-2031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-567-6520
Provider Business Practice Location Address Fax Number:
609-567-6524
Provider Enumeration Date:
12/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BANER
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT & CLINICAL DIRECTOR
Authorized Official Telephone Number:
609-567-6520

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X , with the licence number:  25MA02774400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: 00006367 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1181609 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4442691 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01846797 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20303540A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00909367A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4081038 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2243503 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3700047800 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: L00128 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8588708 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com