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General NPI Number Information
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NPI Number | 1356371561
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Entity Type | Organization
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Legal Business Name | TRI STATE LUNG & SLEEP ASSOCIATES, INC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 16218 SAINT CLAIR AVE
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-9449
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Country | US
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Telephone | 330-382-9355
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Fax | 330-382-9448
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Provider Business Mailing Address
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Address Line | 16218 SAINT CLAIR AVENUE
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-0076
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Country | US
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Telephone | 330-382-9355
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Fax | 330-382-9448
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Authorized Official
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Title or Position | PRESIDENT
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Name | GHULAM R AZIZ
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Credential | M.D.
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Telephone | 330-382-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | OH35-07-9747A
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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