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General NPI Number Information
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NPI Number | 1558468066
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Entity Type | Organization
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Legal Business Name | SOUTH JERSEY ALLERGY AND ASTHMA ASSOC
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Dates
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Enumeration Date | 09/19/2006
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 108 KINGS HWY S
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2504
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Country | US
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Telephone | 856-428-5120
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Fax | 856-428-0264
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Provider Business Mailing Address
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Address Line | 108 KINGS HWY S
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2504
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Country | US
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Telephone | 856-428-5120
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Fax | 856-428-0264
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | LINDA M GRAZIANO
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Credential | MD
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Telephone | 856-428-5120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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