NPIMap

Atlantic Allergy, Asthma & Immunology Associates of NJ LLC

Organization Active NPI Allergy & Immunology Physician · Ocean, NJ

NPI 1508893033 · NPPES record last updated May 28, 2010

Key facts

NPI
1508893033
Entity type
Organization (NPI type 2)
Primary specialty
Allergy & Immunology Physician 207K00000X
Legal business name
ATLANTIC ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES OF NJ LLC
Practice address
802 W Park Ave
Ste 213
Ocean, NJ 07712
Phone
(732) 695-2555
Fax
(732) 695-2552
NPI assigned
Jun 28, 2006
Organization subpart
No

Authorized official

Name
Gary L Gross, MD
Title
Owner
Phone
(732) 695-2555

Practitioners 7

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

National Provider Directory

Locations

8 Tindall Rd
Middletown, NJ 07748
Phone (732) 671-7676

802 W Park Ave
Ste 213
Ocean, NJ 07712
Phone (732) 631-8976

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207K00000X Yes

Addresses

Primary practice location

802 W Park Ave
Ste 213
Ocean, NJ 07712

Mailing address

802 W Park Ave
Ste 213
Ocean, NJ 07712
Phone (732) 695-2555

Other identifiers

IdentifierTypeStateIssuer
7315805MedicaidNJ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 28, 2010.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275004800000",
    "number": "1508893033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 W PARK AVE",
            "address_2": "STE 213",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "732-695-2555",
            "fax_number": "732-695-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 W PARK AVE",
            "address_2": "STE 213",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "732-695-2555",
            "fax_number": "732-695-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC ALLERGY, ASTHMA & IMMUNOLOGY ASSOCIATES OF NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2010-05-28",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-695-2555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7315805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean, NJ

All providers in Ocean, NJ · Allergy & Immunology Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.