Basic Information
Provider Information
NPI: 1780634618
EntityType: 2
ReplacementNPI:  
OrganizationName: NORTH SHORE PULMONARY ASSOCIATES, INC
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Mailing Information
Address1: 55 HIGHLAND AVE
Address2: SUITE 104
City: SALEM
State: MA
PostalCode: 019702100
CountryCode: US
TelephoneNumber: 9787454489
FaxNumber: 9783542085
Practice Location
Address1: 55 HIGHLAND AVE
Address2: SUITE 104
City: SALEM
State: MA
PostalCode: 019702100
CountryCode: US
TelephoneNumber: 9787454489
FaxNumber: 9783542085
Other Information
ProviderEnumerationDate: 05/11/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: SHORE
AuthorizedOfficialFirstName: NEIL
AuthorizedOfficialMiddleName: S.
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 9787454489
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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