# ALLERGY ASTHMA AND IMMUNOLOGY MANAGEMENT PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013972546
- **Authorized official:** STANLEY LANE MD (PRESIDENT)
- **Authorized official phone:** (856) 235-2651

## Contact information

- **Practice address:** 701 E MAIN STREET, VICTORIA MEDICAL ARTS BLDG, MOORESTOWN, NJ 08057
- **Practice address phone:** (856) 235-2651
- **Practice address fax:** (856) 231-1005
- **Mailing address:** 701 E MAIN STREET, VICTORIA MEDICAL ARTS BLDG, MOORESTOWN, NJ 08057
- **Mailing address phone:** (856) 235-2651
- **Mailing address fax:** (856) 231-9812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | 25MA02538600 | NJ | Yes |

## Other

- **Enumeration date:** 04/18/2006
- **Last updated:** 11/23/2011