Basic Information
| Provider Information | |||||||||
| NPI: | 1144246752 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABINGTON PULMONARY & CRITICAL CARE ASSOCIATES, LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1235 OLD YORK RD | ||||||||
| Address2: | STE 121 | ||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155171200 | ||||||||
| FaxNumber: | 2155171219 | ||||||||
| Practice Location | |||||||||
| Address1: | 1235 OLD YORK RD | ||||||||
| Address2: | STE 121 | ||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155171200 | ||||||||
| FaxNumber: | 2155171219 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 11/20/2012 | ||||||||
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| AuthorizedOfficialLastName: | MISHEL | ||||||||
| AuthorizedOfficialFirstName: | HENRY | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2155171200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 261QS1200X | MD16830E | PA | N | Ambulatory Health Care Facilities | Clinic/Center | Sleep Disorder Diagnostic | 207RC0200X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0011011150014 | 05 | PA | MEDICAID |