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General NPI Number Information
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NPI Number | 1699064113
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Entity Type | Organization
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Legal Business Name | LUNG DOCS OF CT PC
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 06/04/2018
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Provider Practice Location Address
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Address Line | 512 BOSTON POST ROAD
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City | ORANGE
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State | CT
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Zip | 06477
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Country | US
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Telephone | 203-523-0971
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Fax | 203-529-3273
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Provider Business Mailing Address
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Address Line | 163 UNIVERSAL DR N
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City | NORTH HAVEN
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State | CT
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Zip | 06473-3152
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Country | US
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Telephone | 203-466-8060
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Fax | 203-907-3279
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Authorized Official
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Title or Position | OWNER
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Name | JASDEEP SIDANA
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Credential | MD
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Telephone | 203-523-0971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | 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 | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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