Healthcare Provider Details

I. General information

NPI: 1174828891
Provider Name (Legal Business Name): CHARLOTTESVILLE ALLERGY & RESPIRATORY ENTERPRISES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 12/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 INSURANCE LN
CHARLOTTESVILLE VA
22911-7229
US

IV. Provider business mailing address

1532 INSURANCE LN
CHARLOTTESVILLE VA
22911-7229
US

V. Phone/Fax

Practice location:
  • Phone: 434-295-2727
  • Fax: 434-295-2777
Mailing address:
  • Phone: 434-295-2727
  • Fax: 434-295-2777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number StateVA

VIII. Authorized Official

Name: DR. ARVIND MADAAN
Title or Position: OWNER
Credential: MD
Phone: 434-546-6517