Organization Active NPI

Allergy Alliance Group LLC

  • Allergy & Immunology Physician
  • Fort Lee, NJ
National Provider Identifier
1740216969
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
25MA03161600 Issued in NJ
Legal business name
ALLERGY ALLIANCE GROUP LLC
Practice address
811 Abbott Blvd
Fort Lee, NJ 07024-4101
Phone
(201) 224-2256
Fax
(201) 224-5577
NPI assigned
Jun 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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. Maryann Jaqueline Colenda, MD
Title
MD/Owner
Phone
(201) 224-2256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 25MA03161600 NJ Primary

Addresses

Primary practice location

811 Abbott Blvd
Fort Lee, NJ 07024-4101

Mailing address

811 Abbott Blvd
Fort Lee, NJ 07024-4101
Phone (201) 224-2256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051025000174 NJ Part B Supplier - Clinic/Group Practice 8426075961 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lee, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740216969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 ABBOTT BLVD",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244101",
            "telephone_number": "201-224-2256",
            "fax_number": "201-224-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 ABBOTT BLVD",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244101",
            "telephone_number": "201-224-2256",
            "fax_number": "201-224-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY ALLIANCE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLENDA",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_middle_name": "JAQUELINE",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "201-224-2256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA03161600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, 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.