Provider Demographics
NPI:1710272679
Name:ADVANCED PULMONARY & CRITICAL CARE SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED PULMONARY & CRITICAL CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERIF
Authorized Official - Middle Name:
Authorized Official - Last Name:LATEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-920-6213
Mailing Address - Street 1:86 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3407
Mailing Address - Country:US
Mailing Address - Phone:201-920-6213
Mailing Address - Fax:
Practice Address - Street 1:86 LAKE ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3407
Practice Address - Country:US
Practice Address - Phone:201-920-6213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07703900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty