MEDICARE: PULMONARY DIEASE ASSOCIATION

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

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	:	1740383355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PULMONARY DIEASE ASSOCIATION

Provider Business Mailing Address
First Line	:	1726 S BROAD ST
Second Line	:	STE 103
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145
Country	:	US
Telephone Number	:	215-463-5008
Fax Number	:	215-463-4223

Provider Business Practice Location Address
First Line	:	1726 S BROAD ST
Second Line	:	STE 103
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145
Country	:	US
Telephone Number	:	215-463-5008
Fax Number	:	215-463-4223

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MARILYN SLINKA
Credential	:
Telephone Number	:	215-463-5008

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	11/28/2012

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Directions to “PULMONARY DIEASE ASSOCIATION ” Practice Location

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