Provider Demographics
NPI:1851538870
Name:ATLANTIC SLEEP AND PULMONARY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ATLANTIC SLEEP AND PULMONARY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:L
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-822-2772
Mailing Address - Street 1:300 MADISON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940
Mailing Address - Country:US
Mailing Address - Phone:973-822-2772
Mailing Address - Fax:973-822-2773
Practice Address - Street 1:300 MADISON AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-1868
Practice Address - Country:US
Practice Address - Phone:973-822-2772
Practice Address - Fax:973-822-2773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05147800207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty