Healthcare Provider Details

I. General information

NPI: 1851338024
Provider Name (Legal Business Name): ALLERGY AND ASTHMA CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 MARIETTA AVE ALLERGY & ASTHMA CENTER
LANCASTER PA
17601-1942
US

IV. Provider business mailing address

2445 MARIETTA AVE
LANCASTER PA
17601-1942
US

V. Phone/Fax

Practice location:
  • Phone: 717-393-1365
  • Fax: 717-393-8540
Mailing address:
  • Phone: 717-393-1365
  • Fax: 717-393-8540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK J TITI
Title or Position: MD/PRESIDENT
Credential: MD
Phone: 717-393-1365