Provider Demographics
NPI:1073521159
Name:HISPANIC RESPIRATORY SERVICES INC
Entity Type:Organization
Organization Name:HISPANIC RESPIRATORY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMANZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-942-9248
Mailing Address - Street 1:285 AYCRIGG AVE
Mailing Address - Street 2:SUITE 14A
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-3737
Mailing Address - Country:US
Mailing Address - Phone:973-767-2249
Mailing Address - Fax:
Practice Address - Street 1:335 PASSAIC ST
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5818
Practice Address - Country:US
Practice Address - Phone:973-942-9248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA003003002278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6419801Medicaid
NJ6419801Medicaid