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General NPI Number Information
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NPI Number | 1043343270
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Entity Type | Organization
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Legal Business Name | ASTHMA AND PULMONARY DIAGNOSTIC ASSOCIATES
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 707 WHITE HORSE PIKE STE D4
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City | ABSECON
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State | NJ
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Zip | 08201-1462
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Country | US
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Telephone | 866-905-6436
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Fax | 609-625-0174
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Provider Business Mailing Address
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Address Line | 707 WHITE HORSE PIKE STE D4
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City | ABSECON
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State | NJ
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Zip | 08201-1462
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Country | US
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Telephone | 866-905-6436
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Fax | 609-625-0174
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Authorized Official
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Title or Position | EXECUTOR
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Name | MRS. BETSY JAYNE
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Credential |
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Telephone | 866-905-6436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 25MA03975500
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License Number State | NJ
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