Provider Demographics
NPI:1245382142
Name:PULMONARY & CRITICAL CARE ASSOCIATES,PA
Entity Type:Organization
Organization Name:PULMONARY & CRITICAL CARE ASSOCIATES,PA
Other - Org Name:PCCA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-632-7892
Mailing Address - Street 1:7 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2910
Mailing Address - Country:US
Mailing Address - Phone:732-632-7892
Mailing Address - Fax:732-210-0207
Practice Address - Street 1:7 MARSHALL DR
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2910
Practice Address - Country:US
Practice Address - Phone:732-632-7892
Practice Address - Fax:732-210-0207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3232107Medicaid
NJ3232107Medicaid