Healthcare Provider Details

I. General information

NPI: 1326971870
Provider Name (Legal Business Name): PULMONARY AND SLEEP SPECIALISTS OF NJ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 HIGHLAND AVE STE 101
GLEN RIDGE NJ
07028-1522
US

IV. Provider business mailing address

123 HIGHLAND AVE STE 101
GLEN RIDGE NJ
07028-1522
US

V. Phone/Fax

Practice location:
  • Phone: 973-744-9125
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
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: LAXMINARAYAN PRABHAKAR
Title or Position: PULMONARY AND SLEEP PHYSICIAN
Credential: MD
Phone: 973-744-9125