Provider Demographics
NPI:1699927079
Name:ADVANCED PULMONARY AND CRITICAL CARE MEDICINE PA
Entity type:Organization
Organization Name:ADVANCED PULMONARY AND CRITICAL CARE MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-325-4360
Mailing Address - Street 1:120 CARNIE BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4520
Mailing Address - Country:US
Mailing Address - Phone:856-325-4360
Mailing Address - Fax:
Practice Address - Street 1:120 CARNIE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4520
Practice Address - Country:US
Practice Address - Phone:856-325-4360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA70224174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty