Healthcare Provider Details

I. General information

NPI: 1972945632
Provider Name (Legal Business Name): ALLERGY BETTER CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 OLD SHORT HILLS RD STE 110
LIVINGSTON NJ
07039-5605
US

IV. Provider business mailing address

22 OLD SHORT HILLS RD STE 110
LIVINGSTON NJ
07039-5605
US

V. Phone/Fax

Practice location:
  • Phone: 973-517-4551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number25MA09206700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA09206700
License Number StateNJ

VIII. Authorized Official

Name: ANDREW P SIDAMON-ERISTOFF
Title or Position: STATE TREASURER
Credential:
Phone: 18008294933