Provider Demographics
NPI:1912136458
Name:THE HEART-LUNG ASSOCIATES OF AMERICA,PC
Entity Type:Organization
Organization Name:THE HEART-LUNG ASSOCIATES OF AMERICA,PC
Other - Org Name:WOUND HEALING INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:STROBECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-423-9388
Mailing Address - Street 1:297 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-1919
Mailing Address - Country:US
Mailing Address - Phone:973-423-9388
Mailing Address - Fax:973-423-2502
Practice Address - Street 1:290 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-1961
Practice Address - Country:US
Practice Address - Phone:973-423-9388
Practice Address - Fax:973-423-2502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04029800174400000X
NJ25MA03176700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJST461797Medicare PIN
NJ449928Medicare PIN