Provider Demographics
NPI:1700823499
Name:PULMONARY CRITICAL CARE AND SLEEP ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:PULMONARY CRITICAL CARE AND SLEEP ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-521-3838
Mailing Address - Street 1:1098 W BALTIMORE PIKE STE 3402
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5139
Mailing Address - Country:US
Mailing Address - Phone:610-565-3250
Mailing Address - Fax:610-892-0948
Practice Address - Street 1:1098 W BALTIMORE PIKE STE 3402
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:610-565-3250
Practice Address - Fax:610-892-0948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015121220001Medicaid
PA1766461OtherBLUE CROSS BLUE SHIELD
PA095449Medicare ID - Type Unspecified