Provider Demographics
NPI:1780877118
Name:NORTH SHORE PULMONARY ASSOC LLP
Entity type:Organization
Organization Name:NORTH SHORE PULMONARY ASSOC LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARBAKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-928-3444
Mailing Address - Street 1:60 NORTH COUNTRY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777
Mailing Address - Country:US
Mailing Address - Phone:631-928-3444
Mailing Address - Fax:631-928-3459
Practice Address - Street 1:60 NORTH COUNTRY RD
Practice Address - Street 2:SUITE 203
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777
Practice Address - Country:US
Practice Address - Phone:631-928-3444
Practice Address - Fax:631-928-3459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty