Provider Demographics
NPI:1538222864
Name:SOMERSET PULMONARY AND CRITICAL CARE ASSOCIATES, PA
Entity type:Organization
Organization Name:SOMERSET PULMONARY AND CRITICAL CARE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-722-5115
Mailing Address - Street 1:245 UNION AVE
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3064
Mailing Address - Country:US
Mailing Address - Phone:908-722-5115
Mailing Address - Fax:908-722-9515
Practice Address - Street 1:245 UNION AVE
Practice Address - Street 2:SUITE 2C
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3064
Practice Address - Country:US
Practice Address - Phone:908-722-5115
Practice Address - Fax:908-722-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5334004Medicaid
NJ5334004Medicaid