Healthcare Provider Details

I. General information

NPI: 1023230323
Provider Name (Legal Business Name): WESTSIDE PULMONARY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 W 125TH ST
NEW YORK NY
10027-4820
US

IV. Provider business mailing address

374 W 125TH ST
NEW YORK NY
10027-4820
US

V. Phone/Fax

Practice location:
  • Phone: 212-749-7960
  • Fax: 212-663-7235
Mailing address:
  • Phone: 212-749-7960
  • Fax: 212-663-7235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number182478
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number182478
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number168952
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number168952
License Number StateNY

VIII. Authorized Official

Name: DR. JOSEPH GHASSIBI
Title or Position: PRESIDENT
Credential: MD
Phone: 212-749-7960