Provider Demographics
NPI:1487666889
Name:SOUTH JERSEY PULMONARY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:SOUTH JERSEY PULMONARY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KROL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-935-0276
Mailing Address - Street 1:310 WOODSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NJ
Mailing Address - Zip Code:08079-2064
Mailing Address - Country:US
Mailing Address - Phone:856-935-0276
Mailing Address - Fax:856-935-1638
Practice Address - Street 1:310 WOODSTOWN RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2064
Practice Address - Country:US
Practice Address - Phone:856-935-0276
Practice Address - Fax:856-935-1638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty