Provider Demographics
NPI:1194154922
Name:FAMILY CENTER FOR ALLERGY AND ASTHMA PC
Entity type:Organization
Organization Name:FAMILY CENTER FOR ALLERGY AND ASTHMA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-747-5777
Mailing Address - Street 1:2605 JOPPA RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5164
Mailing Address - Country:US
Mailing Address - Phone:717-747-5777
Mailing Address - Fax:717-747-5222
Practice Address - Street 1:2605 JOPPA RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5164
Practice Address - Country:US
Practice Address - Phone:717-747-5777
Practice Address - Fax:717-747-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG09351Medicare UPIN