Provider Demographics
NPI:1821147687
Name:ALLERGY & IMMUNOLOGY ON MADISON 069478
Entity Type:Organization
Organization Name:ALLERGY & IMMUNOLOGY ON MADISON 069478
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALOGNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-424-0400
Mailing Address - Street 1:PO BOX 1969
Mailing Address - Street 2:MURRAY HILL STATION
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10561
Mailing Address - Country:US
Mailing Address - Phone:646-424-0400
Mailing Address - Fax:646-742-0092
Practice Address - Street 1:161 MADISON AVE SUITE 3A
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:646-424-0400
Practice Address - Fax:646-742-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7539606Medicaid
750861Medicare PIN
NJ069478Medicare PIN
NY75076FW531Medicare ID - Type Unspecified