Provider Demographics
NPI:1083134167
Name:PREMIER PULMONOLOGY AND CRITICAL CARE MEDICINE LLC
Entity Type:Organization
Organization Name:PREMIER PULMONOLOGY AND CRITICAL CARE MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:I
Authorized Official - Last Name:ABDELHADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-464-3636
Mailing Address - Street 1:103 RIVER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1016
Mailing Address - Country:US
Mailing Address - Phone:908-464-3636
Mailing Address - Fax:908-464-6711
Practice Address - Street 1:103 RIVER RD STE 101
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1016
Practice Address - Country:US
Practice Address - Phone:908-464-3636
Practice Address - Fax:908-464-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08398600207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty