Healthcare Provider Details

I. General information

NPI: 1194631010
Provider Name (Legal Business Name): LUNG INNOVATIONS NETWORK PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

IV. Provider business mailing address

190 W PARK AVE STE 6
DU BOIS PA
15801-2277
US

V. Phone/Fax

Practice location:
  • Phone: 814-940-1212
  • 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. SANDEEP BANSAL
Title or Position: OWNER
Credential: MD
Phone: 814-940-1212