Provider Demographics
NPI:1336108513
Name:PULMONARY CARE ASSOCIATES PC
Entity type:Organization
Organization Name:PULMONARY CARE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MOIRA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MCNICHOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-766-3343
Mailing Address - Street 1:505 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1751
Mailing Address - Country:US
Mailing Address - Phone:516-766-3039
Mailing Address - Fax:516-764-9296
Practice Address - Street 1:505 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1751
Practice Address - Country:US
Practice Address - Phone:516-766-3039
Practice Address - Fax:516-764-9296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWER261Medicare PIN