Provider Demographics
NPI:1710918982
Name:AIKEN PULMONARY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:AIKEN PULMONARY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANITO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:803-643-1090
Mailing Address - Street 1:68 PHYSICIAN DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-6388
Mailing Address - Country:US
Mailing Address - Phone:803-643-1090
Mailing Address - Fax:803-643-8080
Practice Address - Street 1:68 PHYSICIAN DR
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6388
Practice Address - Country:US
Practice Address - Phone:803-643-1090
Practice Address - Fax:803-643-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2010-01-28
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
SCGP2101Medicaid
SC5836Medicare ID - Type UnspecifiedGROUP PROVIDER NO.