Provider Demographics
NPI:1376921460
Name:MEDCORPS ASTHMA AND PULMONARY SPECIALISTS LLC
Entity Type:Organization
Organization Name:MEDCORPS ASTHMA AND PULMONARY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:SILVEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:856-981-1493
Mailing Address - Street 1:1504 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-3767
Mailing Address - Country:US
Mailing Address - Phone:856-981-1493
Mailing Address - Fax:
Practice Address - Street 1:100 KINGS WAY E STE D1
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2238
Practice Address - Country:US
Practice Address - Phone:856-352-6572
Practice Address - Fax:856-352-6710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207K00000X, 207KA0200X, 207R00000X, 207RA0201X, 207RC0200X, 207RP1001X
NJ25MB09005300275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No275N00000XHospital UnitsMedicare Defined Swing Bed UnitGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1184822850OtherPROVIDER NPI