Basic Information
| Provider Information | |||||||||
| NPI: | 1245209022 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PULMONARY ASSOCIATES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1250 S CEDAR CREST BLVD | ||||||||
| Address2: | STE 205 | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181036224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104398856 | ||||||||
| FaxNumber: | 4842231758 | ||||||||
| Practice Location | |||||||||
| Address1: | 1250 S CEDAR CREST BLVD | ||||||||
| Address2: | STE 205 | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181036224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104398856 | ||||||||
| FaxNumber: | 4842231758 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2006 | ||||||||
| LastUpdateDate: | 12/15/2010 | ||||||||
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| AuthorizedOfficialLastName: | KAUFMAN | ||||||||
| AuthorizedOfficialFirstName: | JAY | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6104356171 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 006649130007 | 05 | PA | MEDICAID |