Provider Demographics
NPI:1740407980
Name:COPD SERVICE
Entity Type:Organization
Organization Name:COPD SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLENIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-571-7700
Mailing Address - Street 1:7240 60TH LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-6117
Mailing Address - Country:US
Mailing Address - Phone:718-571-7700
Mailing Address - Fax:
Practice Address - Street 1:165 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:RUNNEMEDE
Practice Address - State:NJ
Practice Address - Zip Code:08078-1127
Practice Address - Country:US
Practice Address - Phone:718-571-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies