Healthcare Provider Details

I. General information

NPI: 1689114027
Provider Name (Legal Business Name): ASSOCIATES IN PULMONARY AND CRITICAL CARE MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2017
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 DEBARTOLO PLACE SUITE 1630
BOARDMAN OH
44512-6088
US

IV. Provider business mailing address

250 DEBARTOLO PLACE SUITE 1630
BOARDMAN OH
44512-6088
US

V. Phone/Fax

Practice location:
  • Phone: 330-707-5864
  • Fax: 330-707-2210
Mailing address:
  • Phone: 330-707-5864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NICHOLAS GERARD PROIA
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 330-707-5864