Provider Demographics
NPI:1033166863
Name:PULMONARY & CRITICAL MEDICINE GROUP, PC
Entity Type:Organization
Organization Name:PULMONARY & CRITICAL MEDICINE GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:N
Authorized Official - Last Name:FUTERFAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-223-3412
Mailing Address - Street 1:1540 E RACE ST
Mailing Address - Street 2:LOWER LEVEL, REAR
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-9587
Mailing Address - Country:US
Mailing Address - Phone:484-223-3412
Mailing Address - Fax:484-223-3419
Practice Address - Street 1:1540 E RACE ST
Practice Address - Street 2:LOWER LEVEL, REAR
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-9587
Practice Address - Country:US
Practice Address - Phone:484-223-3412
Practice Address - Fax:484-223-3419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046660L207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012938920001Medicaid
PAF31253Medicare UPIN
PA145356Medicare ID - Type Unspecified