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General NPI Number Information
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NPI Number | 1285754143
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Entity Type | Organization
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Legal Business Name | PEDIATRIC PULMONARY & ASTHMA INSTITUTE,PC
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Dates
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Enumeration Date | 04/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 56 UNION AVE SUITE 3
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City | SOMERVILLE
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State | NJ
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Zip | 08876-2017
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Country | US
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Telephone | 908-526-5212
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Fax |
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Provider Business Mailing Address
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Address Line | 56 UNION AVE SUITE 3
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City | SOMERVILLE
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State | NJ
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Zip | 08876-2017
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Country | US
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Telephone | 908-526-5212
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NELSON L. TURCIOS
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Credential | M.D.
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Telephone | 908-526-5212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 25MA04435400
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License Number State | NJ
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