Healthcare Provider Details

I. General information

NPI: 1568409548
Provider Name (Legal Business Name): ROCKLAND PULMONARY AND MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 10/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CROSFIELD AVENUE STE 318
WEST NYACK NY
10994
US

IV. Provider business mailing address

2 CROSFIELD AVENUE STE 318
WEST NYACK NY
10994
US

V. Phone/Fax

Practice location:
  • Phone: 845-353-5600
  • Fax: 845-353-3474
Mailing address:
  • Phone: 845-353-5600
  • Fax: 845-353-3474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEON HARRIS
Title or Position: PRESIDENT
Credential: MD
Phone: 845-353-5600