Basic Information
| Provider Information | |||||||||
| NPI: | 1578968657 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PULMONARY AND SLEEP MEDICAL PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2912 BRIGHTON 12TH ST STE 1 | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112354722 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189754334 | ||||||||
| FaxNumber: | 7189754337 | ||||||||
| Practice Location | |||||||||
| Address1: | 2523 AVENUE O | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112105230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187871900 | ||||||||
| FaxNumber: | 7189754337 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2014 | ||||||||
| LastUpdateDate: | 10/30/2014 | ||||||||
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| AuthorizedOfficialLastName: | SONI | ||||||||
| AuthorizedOfficialFirstName: | PRABHAT | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWENER | ||||||||
| AuthorizedOfficialTelephone: | 7187871900 | ||||||||
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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 | 192569 | NY | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RS0012X | 192569 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine |
No ID Information.