Healthcare Provider Details

I. General information

NPI: 1669205373
Provider Name (Legal Business Name): PULMONARY CRITICAL CARE AND SLEEP ASSOCIATES OF SOMERSET
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/24/2024
Certification Date: 08/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 JAMES ST
EDISON NJ
08820-3945
US

IV. Provider business mailing address

873 US ROUTE 1 # 1092
NORTH BRUNSWICK NJ
08902-3345
US

V. Phone/Fax

Practice location:
  • Phone: 551-775-1820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: HINESH UPADHYAY
Title or Position: MANAGER/DIRECTOR/CEO/AUTH PERSON
Credential: MD
Phone: 551-775-1820