Provider Demographics
NPI:1619032471
Name:ALLERGY & ASTHMA GROUP LLC
Entity Type:Organization
Organization Name:ALLERGY & ASTHMA GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-683-1071
Mailing Address - Street 1:100 CRAIG RD
Mailing Address - Street 2:STE 204
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8787
Mailing Address - Country:US
Mailing Address - Phone:732-683-1071
Mailing Address - Fax:732-683-1070
Practice Address - Street 1:717 N BEERS ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1524
Practice Address - Country:US
Practice Address - Phone:732-739-0660
Practice Address - Fax:732-739-1406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ328110801Medicaid
047089Medicare ID - Type Unspecified