Organization Active NPI

Allergy Asthma and Immunology Management PA

  • Allergy & Immunology Physician
  • Moorestown, NJ
National Provider Identifier
1013972546
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
25MA02538600 Issued in NJ
Legal business name
ALLERGY ASTHMA AND IMMUNOLOGY MANAGEMENT PA
Practice address
701 E Main Street
Victoria Medical Arts BLDG
Moorestown, NJ 08057
Phone
(856) 235-2651
Fax
(856) 231-1005
NPI assigned
Apr 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Authorized official

Name
Stanley Lane, MD
Title
President
Phone
(856) 235-2651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X 25MA02538600 NJ Primary

Addresses

Primary practice location

701 E Main Street
Victoria Medical Arts BLDG
Moorestown, NJ 08057

Mailing address

701 E Main Street
Victoria Medical Arts BLDG
Moorestown, NJ 08057
Phone (856) 235-2651

Other identifiers 1

IdentifierTypeStateIssuer
0189502MedicaidNJ

National Provider Directory

National Provider Directory

Locations

701 E Main St
Ste 6
Moorestown, NJ 08057
Phone (856) 235-2651

Practitioners & affiliated clinicians

Practitioners 1

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": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322006400000",
    "number": "1013972546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E MAIN STREET",
            "address_2": "VICTORIA MEDICAL ARTS BLDG",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "08057",
            "telephone_number": "856-235-2651",
            "fax_number": "856-231-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E MAIN STREET",
            "address_2": "VICTORIA MEDICAL ARTS BLDG",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "08057",
            "telephone_number": "856-235-2651",
            "fax_number": "856-231-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY ASTHMA AND IMMUNOLOGY MANAGEMENT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2011-11-23",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-235-2651",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA02538600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0189502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.