Organization
ALLERGY ASTHMA AND IMMUNOLOGY MANAGEMENT PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY LANE MD (PRESIDENT)
(856) 235-2651
Entity
Organization
Contact information
Practice address
701 E MAIN STREET, VICTORIA MEDICAL ARTS BLDG, MOORESTOWN, NJ 08057
(856) 235-2651
(856) 231-1005
Mailing address
701 E MAIN STREET, VICTORIA MEDICAL ARTS BLDG, MOORESTOWN, NJ 08057
(856) 235-2651
(856) 231-9812
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
25MA02538600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0189502
—
NJ
Enumeration date
04/18/2006
Last updated
11/23/2011
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