Provider Demographics
NPI:1033278957
Name:ATLANTIC PULMONARY AND SLEEP DISORDERS ASSOCIATION PA
Entity Type:Organization
Organization Name:ATLANTIC PULMONARY AND SLEEP DISORDERS ASSOCIATION PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AGNIESZKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALECKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-727-7103
Mailing Address - Street 1:873 GOOSE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3621
Mailing Address - Country:US
Mailing Address - Phone:732-727-7103
Mailing Address - Fax:
Practice Address - Street 1:600 MULE RD
Practice Address - Street 2:UNIT15
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757
Practice Address - Country:US
Practice Address - Phone:609-660-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07931500261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty