Provider Demographics
NPI:1205923620
Name:PULMONARY AND INTERNAL MEDICINE ASSOCIATES PA
Entity type:Organization
Organization Name:PULMONARY AND INTERNAL MEDICINE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAYTHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBIZEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-252-6408
Mailing Address - Street 1:3379 QUAKERBRIDGE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1269
Mailing Address - Country:US
Mailing Address - Phone:215-747-4511
Mailing Address - Fax:
Practice Address - Street 1:40 FULD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-5247
Practice Address - Country:US
Practice Address - Phone:609-695-4358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27964207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2914107Medicaid
132386Medicare PIN