Provider Demographics
NPI:1003853540
Name:DELMARVA SLEEP DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:DELMARVA SLEEP DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:GODLEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-449-5460
Mailing Address - Street 1:104 SLEEPY HOLLOW DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8894
Mailing Address - Country:US
Mailing Address - Phone:302-449-5460
Mailing Address - Fax:302-449-5475
Practice Address - Street 1:104 SLEEPY HOLLOW DR
Practice Address - Street 2:SUITE 203
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-8894
Practice Address - Country:US
Practice Address - Phone:302-449-5460
Practice Address - Fax:302-449-5475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2004206616261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE3096779OtherCIGNA
DEP00227885OtherPALMETTO GBA NORTH REGION
DE1000034930Medicaid
DE3843471OtherAETNA
DEA3619429OtherOXFORD HEALTH
DE268237OtherCOVENTRY
DE2133502OtherMAMSI
DE0000826401OtherDELAWARE PHYSICIANS CARE
DE3096779OtherCIGNA
DE=========OtherINTERGROUP SERVICES
DE268237OtherCOVENTRY
DE=========OtherDEVON HEALTH
DE2133502OtherMAMSI
DE=========OtherBLUE CROSS BLUE SHIELD DE
DE=========OtherHIGHMARK- BCBS PA
DEP00227885OtherPALMETTO GBA NORTH REGION
DE=========OtherUNITED HEALTHCARE
DE=========OtherINTEGRATED HEALTH PLAN
DE=========OtherTRICARE NORTH REGION