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General NPI Number Information
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NPI Number | 1639433410
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Entity Type | Organization
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Legal Business Name | ALLERGY AND ASTHMA COMPREHENSIVE CARE
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 541 CEDAR HILL AVE SUITE 8
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City | WYCKOFF
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State | NJ
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Zip | 07481-2150
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Country | US
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Telephone | 201-652-6211
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Fax | 201-652-0321
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Provider Business Mailing Address
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Address Line | 541 CEDAR HILL AVE SUITE 8
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City | WYCKOFF
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State | NJ
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Zip | 07481-2150
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Country | US
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Telephone | 201-652-6211
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Fax | 201-652-0321
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEXANDER MAROTTA
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Credential | M.D.
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Telephone | 201-906-6247
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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 | 25MA07980000
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License Number State | NJ
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