Provider Demographics
NPI:1689114027
Name:ASSOCIATES IN PULMONARY AND CRITICAL CARE MEDICINE INC
Entity Type:Organization
Organization Name:ASSOCIATES IN PULMONARY AND CRITICAL CARE MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:PROIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-707-5864
Mailing Address - Street 1:250 DEBARTOLO PLACE
Mailing Address - Street 2:SUITE 1630
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6088
Mailing Address - Country:US
Mailing Address - Phone:330-707-5864
Mailing Address - Fax:
Practice Address - Street 1:250 DEBARTOLO PLACE
Practice Address - Street 2:SUITE 1630
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6088
Practice Address - Country:US
Practice Address - Phone:330-707-5864
Practice Address - Fax:330-707-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-05
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0224394Medicaid
OHPENDINGMedicaid