Provider Demographics
NPI:1841487097
Name:LUNG & SLEEP MEDICINE, INC.
Entity type:Organization
Organization Name:LUNG & SLEEP MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-821-1222
Mailing Address - Street 1:PO BOX 66971
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63166-6971
Mailing Address - Country:US
Mailing Address - Phone:314-821-1222
Mailing Address - Fax:314-754-9889
Practice Address - Street 1:13975 MANCHESTER RD
Practice Address - Street 2:SUITE 7
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63011-4500
Practice Address - Country:US
Practice Address - Phone:314-821-1222
Practice Address - Fax:314-754-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3P21207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21754925801Medicaid
MODO2796OtherRAILROAD MEDICARE
MO506120005Medicaid
ILIL1817Medicare PIN
000013766Medicare PIN
MODO2796OtherRAILROAD MEDICARE