Provider Demographics
NPI:1770530933
Name:PULMONARY MEDICINE PC
Entity type:Organization
Organization Name:PULMONARY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PRENTICE
Authorized Official - Last Name:BURLEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-625-8898
Mailing Address - Street 1:5325 NORTHGATE DR
Mailing Address - Street 2:SUITE 209
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9411
Mailing Address - Country:US
Mailing Address - Phone:610-625-8898
Mailing Address - Fax:610-625-8899
Practice Address - Street 1:5325 NORTHGATE DR
Practice Address - Street 2:SUITE 209
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9411
Practice Address - Country:US
Practice Address - Phone:610-625-8898
Practice Address - Fax:610-625-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037049E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA020055700OtherBLACK LUNG
PA02343500OtherCAPITAL BLUE CROSS
PA0618634OtherAETNA
PA91964OtherUNISON
PA290009012OtherRAILROAD MEDICARE
PABU608961OtherPA BLUE SHIELD
PA0012094500002Medicaid
PAP867065OtherOXFORD
PA102955Medicare PIN
PA02343500OtherCAPITAL BLUE CROSS
PA608961Medicare ID - Type Unspecified