Provider Demographics
NPI:1225159932
Name:PULMONARY AND SLEEP OFFICE OF NEW ENGLAND, PC
Entity Type:Organization
Organization Name:PULMONARY AND SLEEP OFFICE OF NEW ENGLAND, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:D
Authorized Official - Last Name:KHAMIEES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-405-0899
Mailing Address - Street 1:3353 MENDON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-2122
Mailing Address - Country:US
Mailing Address - Phone:401-405-0899
Mailing Address - Fax:401-405-0899
Practice Address - Street 1:3353 MENDON RD STE 3
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864
Practice Address - Country:US
Practice Address - Phone:401-405-0899
Practice Address - Fax:401-405-0899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RC0200X, 207RG0300X, 207RP1001X, 332B00000X
RI207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA662189OtherTUFTS HEALTH PLAN
MAM19414OtherBC/BS
RI1225159Medicaid
MA110077761AMedicaid
RI4181OtherNEIGHBORHOOD HEALTH PLAN
RI5961630001Medicare NSC
MA5961630002Medicare NSC
MA662189OtherTUFTS HEALTH PLAN
MAM19414OtherBC/BS