Provider Demographics
NPI:1740346659
Name:SUBURBAN CHEST ASSOCIATES, P.C.
Entity type:Organization
Organization Name:SUBURBAN CHEST ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MROZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-885-6220
Mailing Address - Street 1:314 COTTMAN ST
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2821
Mailing Address - Country:US
Mailing Address - Phone:215-885-6220
Mailing Address - Fax:215-885-2830
Practice Address - Street 1:314 COTTMAN ST
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2821
Practice Address - Country:US
Practice Address - Phone:215-885-6220
Practice Address - Fax:215-885-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006596910002Medicaid
PA0048703000OtherIBC
PA0048703000OtherIBC