Provider Demographics
NPI:1023230323
Name:WESTSIDE PULMONARY PC
Entity type:Organization
Organization Name:WESTSIDE PULMONARY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GHASSIBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-749-7960
Mailing Address - Street 1:374 W 125TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4820
Mailing Address - Country:US
Mailing Address - Phone:212-749-7960
Mailing Address - Fax:212-663-7235
Practice Address - Street 1:374 W 125TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4820
Practice Address - Country:US
Practice Address - Phone:212-749-7960
Practice Address - Fax:212-663-7235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182478207RC0200X, 207RP1001X
NY168952207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE91649Medicare UPIN
NYB12724Medicare UPIN
NYWL1891Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER