Provider Demographics
NPI:1770646804
Name:CAPITAL PULMONARY-INTENSIVIST PHYSICIAN, P.C.
Entity Type:Organization
Organization Name:CAPITAL PULMONARY-INTENSIVIST PHYSICIAN, P.C.
Other - Org Name:CPI PHYSICIANS, P.C: ASSUMED NAME AS OF 4/23/04
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:AZAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-459-1800
Mailing Address - Street 1:319 S MANNING BLVD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1742
Mailing Address - Country:US
Mailing Address - Phone:518-459-1800
Mailing Address - Fax:518-459-1818
Practice Address - Street 1:319 S MANNING BLVD
Practice Address - Street 2:SUITE 116
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1742
Practice Address - Country:US
Practice Address - Phone:518-459-1800
Practice Address - Fax:518-459-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0315Medicare ID - Type Unspecified