Provider Demographics
NPI:1427415512
Name:FAMILY ALLERGY AND AUDIOLOGY PC
Entity Type:Organization
Organization Name:FAMILY ALLERGY AND AUDIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-885-7960
Mailing Address - Street 1:602 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1222
Mailing Address - Country:US
Mailing Address - Phone:856-885-7960
Mailing Address - Fax:856-885-7960
Practice Address - Street 1:602 S BROADWAY
Practice Address - Street 2:RELIANCE BUILDING
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1222
Practice Address - Country:US
Practice Address - Phone:856-885-7960
Practice Address - Fax:856-885-7960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty