Basic Information
| Provider Information | |||||||||
| NPI: | 1801097712 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AM PULMONARY CARE P.C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 103 DEWEY ST | ||||||||
| Address2: | |||||||||
| City: | JERICHO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117531615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166783155 | ||||||||
| FaxNumber: | 5166782465 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 N VILLAGE AVE | ||||||||
| Address2: | STE 102 | ||||||||
| City: | ROCKVILLE CENTRE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115701078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166783155 | ||||||||
| FaxNumber: | 5166785465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2007 | ||||||||
| LastUpdateDate: | 08/14/2008 | ||||||||
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| AuthorizedOfficialLastName: | MAJEED | ||||||||
| AuthorizedOfficialFirstName: | ABDUL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5166783155 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 205511 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 27R241 | 01 | NY | BCBS | OTHER | W55971 | 01 | NY | MEDICARE - EMPIRE | OTHER |