Provider Demographics
NPI:1902988470
Name:CENTER FOR ALLERGY AND ASTHMA CARE, LLC
Entity Type:Organization
Organization Name:CENTER FOR ALLERGY AND ASTHMA CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CILIBERTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-841-3890
Mailing Address - Street 1:250 CETRONIA RD.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104
Mailing Address - Country:US
Mailing Address - Phone:610-841-3890
Mailing Address - Fax:610-841-3880
Practice Address - Street 1:250 CETRONIA RD.
Practice Address - Street 2:SUITE 103
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104
Practice Address - Country:US
Practice Address - Phone:610-841-3890
Practice Address - Fax:610-841-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD043917LOtherMEDICAL LICENSE
PAF65319Medicare UPIN
PA106884Medicare ID - Type Unspecified