Provider Demographics
NPI:1578968657
Name:PULMONARY AND SLEEP MEDICAL PC
Entity Type:Organization
Organization Name:PULMONARY AND SLEEP MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER
Authorized Official - Prefix:
Authorized Official - First Name:PRABHAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-787-1900
Mailing Address - Street 1:2912 BRIGHTON 12TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4722
Mailing Address - Country:US
Mailing Address - Phone:718-975-4334
Mailing Address - Fax:718-975-4337
Practice Address - Street 1:2523 AVENUE O
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-5230
Practice Address - Country:US
Practice Address - Phone:718-787-1900
Practice Address - Fax:718-975-4337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192569207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty