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Organization
ALLEGIANCE MSO LLC
Active
Organization
ALLEGIANCE MSO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANASSE SOUIDI MD (OWNER)
(609) 695-4422
Entity
Organization
Contact information
Practice address
1719 BRUNSWICK AVE, LAWRENCEVILLE, NJ 08648-4665
(609) 337-7925
(609) 337-7938
Mailing address
40 FULD ST, SUITE 201, TRENTON, NJ 08638-5247
(609) 695-4422
(609) 695-4358
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
NULL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
207RI0200X
Infectious Disease Physician
—
NULL
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
NULL
207RR0500X
Rheumatology Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
NULL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
NULL
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/27/2016
Last updated
01/27/2016
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