| Organization Name: | NORTHERN VALLEY ALLERGY ASTHMA AND SINUS CENTER, LLC |
| NPI Number: | 1083922314 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MATHEW VARGHESE (PHYSICIAN) |
| Mailing Address: | 136 N Washington Ave Suite 203 Bergenfield |
| State: | NJ US |
| Postal Code: | 076211776 |
| Phone Number: | 2013741718 |
| Fax Number: | 2013741719 |
| NPI Enumeration Date: | 09/21/2010 |
| NPI Last Update Date: | 02/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207KA0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Allergy & Immunology |
| Taxonomy Specialization: | Allergy |
| Taxonomy Definition: | |