Provider Demographics
NPI:1417503368
Name:ALLERGY AND ASTHMA SPECIALTY PHYSICIANS, LLC
Entity Type:Organization
Organization Name:ALLERGY AND ASTHMA SPECIALTY PHYSICIANS, LLC
Other - Org Name:THE ALLERGY AND ASTHMA DOCTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELECANECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-261-1941
Mailing Address - Street 1:204 ARK RD STE 103B
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3190
Mailing Address - Country:US
Mailing Address - Phone:856-372-5600
Mailing Address - Fax:
Practice Address - Street 1:210 ARK RD STE 109
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3188
Practice Address - Country:US
Practice Address - Phone:856-235-8282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-16
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty