Provider Demographics
NPI:1548257025
Name:PULMONARY ASSOCIATES OF THE SOUTHERN TIER, P.C.
Entity type:Organization
Organization Name:PULMONARY ASSOCIATES OF THE SOUTHERN TIER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:607-732-4823
Mailing Address - Street 1:1001 HOFFMAN ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14905-1605
Mailing Address - Country:US
Mailing Address - Phone:607-732-4823
Mailing Address - Fax:607-733-2526
Practice Address - Street 1:1001 HOFFMAN ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905-1605
Practice Address - Country:US
Practice Address - Phone:607-732-4823
Practice Address - Fax:607-733-2526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY139254-1207RS0012X
NY207RC0200X, 363LA2200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00719168Medicaid
NY00719168Medicaid