Provider Demographics
NPI:1528483807
Name:NORTHEASTERN PULMONARY ASSOCIATES
Entity type:Organization
Organization Name:NORTHEASTERN PULMONARY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:SAUD
Authorized Official - Last Name:ANWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-875-2444
Mailing Address - Street 1:27 NAEK RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-3965
Mailing Address - Country:US
Mailing Address - Phone:860-875-2444
Mailing Address - Fax:860-875-1952
Practice Address - Street 1:27 NAEK RD
Practice Address - Street 2:SUITE 2
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3965
Practice Address - Country:US
Practice Address - Phone:860-875-2444
Practice Address - Fax:860-875-1952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5638363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty