Provider Demographics
NPI:1982890992
Name:MONMOUTH SLEEP & PULMONARY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:MONMOUTH SLEEP & PULMONARY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PRISTAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-747-3666
Mailing Address - Street 1:108 AVENUE OF TWO RIVERS
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-1802
Mailing Address - Country:US
Mailing Address - Phone:732-747-3666
Mailing Address - Fax:732-747-8343
Practice Address - Street 1:108 AVENUE OF TWO RIVERS
Practice Address - Street 2:
Practice Address - City:RUMSON
Practice Address - State:NJ
Practice Address - Zip Code:07760-1802
Practice Address - Country:US
Practice Address - Phone:732-747-3666
Practice Address - Fax:732-747-8343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58104174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF33432Medicare UPIN