MEDICARE: DOVER PULMONARY ASSOCIATES, P.A.

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	174400000X	Specialist

General Provider Information

NPI Number	:	1184762114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOVER PULMONARY ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	508 LAKEHURST RD
Second Line	:	SUITE 1A
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-8000
Country	:	US
Telephone Number	:	732-244-5864
Fax Number	:	732-244-3326

Provider Business Practice Location Address
First Line	:	508 LAKEHURST RD
Second Line	:	SUITE 1A
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-8000
Country	:	US
Telephone Number	:	732-244-5864
Fax Number	:	732-244-3326

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. KATHY STEWART
Credential	:
Telephone Number	:	732-244-5864

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	08/22/2020

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