Provider Demographics
NPI:1215224035
Name:THE MARSHALL P ALLEGRA MD LLC
Entity Type:Organization
Organization Name:THE MARSHALL P ALLEGRA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEGRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-888-8388
Mailing Address - Street 1:879 POOLE AVE
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-2041
Mailing Address - Country:US
Mailing Address - Phone:732-888-8388
Mailing Address - Fax:732-888-5595
Practice Address - Street 1:879 POOLE AVE
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-2041
Practice Address - Country:US
Practice Address - Phone:732-888-8388
Practice Address - Fax:732-888-5595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04454200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty