1033278957 NPI number — ATLANTIC PULMONARY AND SLEEP DISORDERS ASSOCIATION PA

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 1033278957 NPI number — ATLANTIC PULMONARY AND SLEEP DISORDERS ASSOCIATION PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTIC PULMONARY AND SLEEP DISORDERS ASSOCIATION PA
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:
1033278957
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
873 GOOSE CREEK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOMS RIVER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08753-3621
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-727-7103
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 MULE RD
Provider Second Line Business Practice Location Address:
UNIT15
Provider Business Practice Location Address City Name:
TOMS RIVER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-660-8100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PALECKI
Authorized Official First Name:
AGNIESZKA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
732-727-7103

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  MA07931500 , 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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