Organization
TRI STATE LUNG & SLEEP ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHULAM R AZIZ M.D. (PRESIDENT)
(330) 382-9355
Entity
Organization
Contact information
Practice address
16218 SAINT CLAIR AVE, EAST LIVERPOOL, OH 43920-9449
(330) 382-9355
(330) 382-9448
Mailing address
16218 SAINT CLAIR AVENUE, EAST LIVERPOOL, OH 43920-0076
(330) 382-9355
(330) 382-9448
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
OH35-07-9747A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000218659
ANTHEM BCBS
OH
01
—
110233707
RRMC
—
01
—
1408622
HIGHMARK BCBS
PA
01
—
151908826
TRICARE
—
01
—
151908826-00
BWC
OH
01
—
151908826002
MEDICAL MUTUAL OF OHI
OH
05
—
1807927000
—
WV
05
—
2254984
—
OH
01
—
5246690
AETNA
—
01
—
90768
NATIONWIDE HEALTH PLANS
—
Enumeration date
07/04/2006
Last updated
04/03/2020
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