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General NPI Number Information
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NPI Number | 1629594643
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Entity Type | Organization
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Legal Business Name | NORTHEAST PULMONARY AND SLEEP MEDICAL LLC
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 08/22/2017
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Provider Practice Location Address
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Address Line | 506 REGENT STREET SUITE A
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City | LIVINGSTON
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State | NJ
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Zip | 07039
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Country | US
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Telephone | 646-641-4278
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Fax |
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Provider Business Mailing Address
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Address Line | 32 KEYES ST
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-2179
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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 | OWNER
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Name | MIKHAIL LITINSKI
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Credential |
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Telephone | 646-641-4278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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