Provider Demographics
NPI:1215223102
Name:LUNG AND SLEEP SPECIALISTS LLC
Entity Type:Organization
Organization Name:LUNG AND SLEEP SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ATAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-257-7268
Mailing Address - Street 1:6738 CHERRY LEAF CT
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-4127
Mailing Address - Country:US
Mailing Address - Phone:513-257-7268
Mailing Address - Fax:
Practice Address - Street 1:1010 CEREAL AVE
Practice Address - Street 2:STE 212
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2784
Practice Address - Country:US
Practice Address - Phone:513-274-1223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0054338Medicaid
OH0054338Medicaid