Provider Demographics
NPI:1841399342
Name:PEDIATRIC & ADULT ASTHMA AND ALLERGY, P.C
Entity Type:Organization
Organization Name:PEDIATRIC & ADULT ASTHMA AND ALLERGY, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BRUNO
Authorized Official - Last Name:LARUSSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-933-5599
Mailing Address - Street 1:2908 CENTRAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2506
Mailing Address - Country:US
Mailing Address - Phone:205-933-5599
Mailing Address - Fax:205-930-2611
Practice Address - Street 1:2908 CENTRAL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2506
Practice Address - Country:US
Practice Address - Phone:205-933-5599
Practice Address - Fax:205-930-2611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty