Provider Demographics
NPI:1285865501
Name:BRUNSWICK PULMONARY & SLEEP MEDICINE PC
Entity Type:Organization
Organization Name:BRUNSWICK PULMONARY & SLEEP MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVANZO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-416-1431
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:BLAWENBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08504-0297
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1543 STATE HWY 27
Practice Address - Street 2:SUITE 11
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-246-4070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty