Provider Demographics
NPI:1134477615
Name:PULMONARY DIAGNOSTIC SERVICES LLC
Entity Type:Organization
Organization Name:PULMONARY DIAGNOSTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SINACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-207-3388
Mailing Address - Street 1:221 EDGEMERE DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1161
Mailing Address - Country:US
Mailing Address - Phone:732-505-8277
Mailing Address - Fax:732-341-2306
Practice Address - Street 1:331 GRAND ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2719
Practice Address - Country:US
Practice Address - Phone:732-207-3388
Practice Address - Fax:732-341-2306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory