Healthcare Provider Details

I. General information

NPI: 1306802491
Provider Name (Legal Business Name): ALLERGY AND PEDIATRIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 SCHANCK RD
FREEHOLD NJ
07728-2974
US

IV. Provider business mailing address

222 SCHANCK RD
FREEHOLD NJ
07728-2974
US

V. Phone/Fax

Practice location:
  • Phone: 732-431-3373
  • Fax: 732-303-0172
Mailing address:
  • Phone: 732-431-3373
  • Fax: 732-303-0172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: CARL MARCHETTI
Title or Position: DIRECTOR
Credential: M.D.
Phone: 732-431-3373