Provider Demographics
NPI:1174828891
Name:CHARLOTTESVILLE ALLERGY & RESPIRATORY ENTERPRISES PLLC
Entity Type:Organization
Organization Name:CHARLOTTESVILLE ALLERGY & RESPIRATORY ENTERPRISES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:
Authorized Official - Last Name:MADAAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-546-6517
Mailing Address - Street 1:1532 INSURANCE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-7229
Mailing Address - Country:US
Mailing Address - Phone:434-295-2727
Mailing Address - Fax:434-295-2777
Practice Address - Street 1:1532 INSURANCE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-7229
Practice Address - Country:US
Practice Address - Phone:434-295-2727
Practice Address - Fax:434-295-2777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9776Medicare PIN