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General NPI Number Information
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NPI Number | 1285865501
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Entity Type | Organization
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Legal Business Name | BRUNSWICK PULMONARY & SLEEP MEDICINE PC
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 09/04/2009
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Provider Practice Location Address
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Address Line | 1543 STATE HWY 27 SUITE 11
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City | SOMERSET
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State | NJ
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Zip | 08873
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Country | US
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Telephone | 732-246-4070
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 297
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City | BLAWENBURG
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State | NJ
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Zip | 08504-0297
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LAWRENCE DAVANZO
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Credential | DO
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Telephone | 732-416-1431
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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 |
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License Number State |
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