Organization Active NPI

Professional Allergy Associates P.a.

  • Allergy Physician
  • Cherry Hill, NJ
National Provider Identifier
1003945965
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
MA25049 Issued in NJ
Legal business name
PROFESSIONAL ALLERGY ASSOCIATES P.A.
Practice address
1034 Marlton Pike E
Cherry Hill, NJ 08034-2400
Phone
(856) 429-4922
Fax
(856) 429-7780
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nicholas Alexander Romanoff, M.D.NPI 1316903313
Title
President
Phone
(856) 429-4922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207KA0200X MA25049 NJ Primary

Addresses

Primary practice location

1034 Marlton Pike E
Cherry Hill, NJ 08034-2400

Mailing address

1034 Marlton Pike E
Cherry Hill, NJ 08034-2400
Phone (856) 429-4922

Other identifiers 1

IdentifierTypeStateIssuer
1161601MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100323000064 NJ Part B Supplier - Clinic/Group Practice 8921133463 Receives reassigned benefits from 1 practitioner
Practice locations: Cherry Hill, NJ; Northfield, NJ

National Provider Directory

National Provider Directory

Locations

1750 Zion Rd
Northfield, NJ 08225
Phone (609) 641-4947

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003945965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 MARLTON PIKE E",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342400",
            "telephone_number": "856-429-4922",
            "fax_number": "856-429-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 MARLTON PIKE E",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342400",
            "telephone_number": "856-429-4922",
            "fax_number": "856-429-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ALLERGY ASSOCIATES P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROMANOFF",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-429-4922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "NJ",
            "license": "MA25049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1161601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.