Provider Demographics
NPI:1578628889
Name:ASTHMA & ALLERGY SOLUTIONS, INC.
Entity type:Organization
Organization Name:ASTHMA & ALLERGY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BANER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-567-6520
Mailing Address - Street 1:858 S WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2031
Mailing Address - Country:US
Mailing Address - Phone:609-567-6520
Mailing Address - Fax:609-567-6524
Practice Address - Street 1:858 S WHITE HORSE PIKE
Practice Address - Street 2:SUITE 6
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2031
Practice Address - Country:US
Practice Address - Phone:609-567-6520
Practice Address - Fax:609-567-6524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02774400207K00000X
NJ00006367291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1181609Medicaid
MI4442691Medicaid
PA01846797Medicaid
IN20303540AMedicaid
GA00909367AMedicaid
TN4081038Medicaid
OH2243503Medicaid
KY3700047800Medicaid
SCL00128Medicaid
NJ8588708Medicaid
GA00909367AMedicaid