Provider Demographics
NPI:1780779512
Name:COMPREHENSIVE PULMONARY AND CRITICAL CARE PC
Entity type:Organization
Organization Name:COMPREHENSIVE PULMONARY AND CRITICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HIMANSHU
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-763-6800
Mailing Address - Street 1:96 MILLBURN AVE
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1944
Mailing Address - Country:US
Mailing Address - Phone:973-763-6800
Mailing Address - Fax:972-763-1255
Practice Address - Street 1:96 MILLBURN AVE
Practice Address - Street 2:SUITE 200A
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1944
Practice Address - Country:US
Practice Address - Phone:973-763-6800
Practice Address - Fax:972-763-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ612494Medicare PIN