Provider Demographics
NPI:1740607480
Name:PULMONOLOGY AND ALLERGY ASSOCIATES
Entity Type:Organization
Organization Name:PULMONOLOGY AND ALLERGY ASSOCIATES
Other - Org Name:PULMONOLOGY AND ALLERGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYOUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-513-8923
Mailing Address - Street 1:1650 45TH AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-3962
Mailing Address - Country:US
Mailing Address - Phone:219-513-8923
Mailing Address - Fax:
Practice Address - Street 1:1650 45TH AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3962
Practice Address - Country:US
Practice Address - Phone:219-513-8923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058949261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center