Provider Demographics
NPI:1982729687
Name:PULMONARY MEDICINE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:PULMONARY MEDICINE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SAKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-493-0366
Mailing Address - Street 1:1 W RIDGEWOOD AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2359
Mailing Address - Country:US
Mailing Address - Phone:201-493-0366
Mailing Address - Fax:201-493-0379
Practice Address - Street 1:1 W RIDGEWOOD AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2359
Practice Address - Country:US
Practice Address - Phone:201-493-0366
Practice Address - Fax:201-493-0379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03030900207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0794406Medicaid
NJ2951703Medicaid
NJ0794601Medicaid
NJC63112Medicare UPIN
NJ136868BW2Medicare PIN
NJ0794601Medicaid
NJ2951703Medicaid
NJ0794406Medicaid