MEDICARE: JOSE PINAL, M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	25MA03550000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164860631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSE PINAL, M.D., P.C.

Provider Business Mailing Address
First Line	:	526 42ND ST
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-2989
Country	:	US
Telephone Number	:	201-865-9195
Fax Number	:	201-865-4416

Provider Business Practice Location Address
First Line	:	526 42ND ST
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-2989
Country	:	US
Telephone Number	:	201-865-9195
Fax Number	:	201-865-4416

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSE PINAL
Credential	:	M.D.
Telephone Number	:	201-865-9195

Provider Enumeration Date	:	06/06/2013
Last Update Date	:	06/06/2013

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