1609002823 NPI number — WEST HUDSON PULMONARY ASSOCIATES CORPC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609002823 NPI number — WEST HUDSON PULMONARY ASSOCIATES CORPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEST HUDSON PULMONARY ASSOCIATES CORPC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609002823
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
816 KEARNY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KEARNY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07032-3148
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-991-4544
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
816 KEARNY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KEARNY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07032-3148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-991-4544
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SALIBA
Authorized Official First Name:
JEHAD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRES
Authorized Official Telephone Number:
201-991-4544

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  0400287406 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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