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MARYVILLE PULMONARY & SLEEP MEDICINE LLC NPI 1053620765


NPI Information

NPI: 1053620765
Provider Name: MARYVILLE PULMONARY & SLEEP MEDICINE, LLC
Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

Address:
5401 OLD YORK ROAD
KLEIN-SUITE 300
PHILADELPHIA, PA
ZIP 19141
Phone: (215) 456-6950
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MARYVILLE PULMONARY & SLEEP MEDICINE, LLC is a pulmonary disease internal medicine in Philadelphia, PA. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. MARYVILLE PULMONARY & SLEEP MEDICINE, LLC NPI is 1053620765. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5401 OLD YORK ROAD
KLEIN-SUITE 300
PHILADELPHIA, PA
ZIP 19141-030
Phone: (215) 456-6950
Fax: (215) 456-1766

The provider's authorized official is Jaber M. Monla-hassan .
The authorized official title is Owner and has the following contact phone number (865) 980-5100.

The enumeration date for this NPI number is 9/29/2010 and was last updated on 3/17/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RP1001XInternal MedicinePulmonary Disease38341TENNESSEENo
2207RP1001XInternal MedicinePulmonary DiseaseMD433403PENNSYLVANIAYes
3207RS0012XInternal MedicineSleep Medicine38341TENNESSEENo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11520768MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.