Healthcare Provider Details

I. General information

NPI: 1679876205
Provider Name (Legal Business Name): BUXMONT PULMONARY & SLEEP MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2010
Last Update Date: 12/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 INVERNESS DR
BLUE BELL PA
19422-3202
US

IV. Provider business mailing address

118 INVERNESS DR
BLUE BELL PA
19422-3202
US

V. Phone/Fax

Practice location:
  • Phone: 832-419-1091
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RUBINA N HAIDAR
Title or Position: OWNER
Credential:
Phone: 832-419-1091