Healthcare Provider Details
I. General information
NPI: 1265431217
Provider Name (Legal Business Name): ALLENTOWN ASTHMA & ALLERGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/20/2005
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1605 N CEDAR CREST BLVD SUITE 605
ALLENTOWN PA
18104-2351
US
IV. Provider business mailing address
1605 N CEDAR CREST BLVD SUITE 605
ALLENTOWN PA
18104-2351
US
V. Phone/Fax
- Phone: 610-820-9000
- Fax: 610-820-9078
- Phone: 610-820-9000
- Fax: 610-820-9078
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207KI0005X |
| Taxonomy | Clinical & Laboratory Immunology (Allergy & Immunology) Physician |
| License Number | MD423801 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | VP004607D |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207KI0005X |
| Taxonomy | Clinical & Laboratory Immunology (Allergy & Immunology) Physician |
| License Number | MD045375E |
| License Number State | PA |
VIII. Authorized Official
Name:
HOWARD
AARON
ISRAEL
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 610-820-9000