Provider Demographics
NPI:1457431678
Name:NORTHERN PULMONARY MEDICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:NORTHERN PULMONARY MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOLARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-224-8900
Mailing Address - Street 1:5806 FRANCIS LEWIS BLVD
Mailing Address - Street 2:1ST FL
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1637
Mailing Address - Country:US
Mailing Address - Phone:718-224-8900
Mailing Address - Fax:718-224-6867
Practice Address - Street 1:5806 FRANCIS LEWIS BLVD
Practice Address - Street 2:1ST FL
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-1637
Practice Address - Country:US
Practice Address - Phone:718-224-8900
Practice Address - Fax:718-224-5184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55415Medicare PIN