Healthcare Provider Details

I. General information

NPI: 1982890992
Provider Name (Legal Business Name): MONMOUTH SLEEP & PULMONARY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 AVENUE OF TWO RIVERS
RUMSON NJ
07760-1802
US

IV. Provider business mailing address

108 AVENUE OF TWO RIVERS
RUMSON NJ
07760-1802
US

V. Phone/Fax

Practice location:
  • Phone: 732-747-3666
  • Fax: 732-747-8343
Mailing address:
  • Phone: 732-747-3666
  • Fax: 732-747-8343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA58104
License Number StateNJ

VIII. Authorized Official

Name: DR. ADRIAN MICHAEL PRISTAS
Title or Position: OWNER
Credential: M.D.
Phone: 732-747-3666