Provider Demographics
NPI:1346280518
Name:PULMONARY & ALLERGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:PULMONARY & ALLERGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-934-0555
Mailing Address - Street 1:1 SPRINGFIELD AVE
Mailing Address - Street 2:3A
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07091
Mailing Address - Country:US
Mailing Address - Phone:908-934-0555
Mailing Address - Fax:908-934-0556
Practice Address - Street 1:1 SPRINGFIELD AVE
Practice Address - Street 2:STE 3A
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-4055
Practice Address - Country:US
Practice Address - Phone:908-934-0555
Practice Address - Fax:908-934-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04968100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ290002887OtherRAIL ROAD MEDICARE
NJ134759Medicare ID - Type UnspecifiedPHYSICIAN OFFICE