Provider Demographics
NPI:1023044344
Name:SLEEP DISORDER DIAGNOSTIC CENTER, LLC
Entity Type:Organization
Organization Name:SLEEP DISORDER DIAGNOSTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHIVOTOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-696-2426
Mailing Address - Street 1:2323 S TROY ST STE 4-100
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1982
Mailing Address - Country:US
Mailing Address - Phone:303-696-2426
Mailing Address - Fax:303-696-2436
Practice Address - Street 1:2323 S TROY ST STE 4-100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80014-1982
Practice Address - Country:US
Practice Address - Phone:303-696-2426
Practice Address - Fax:303-696-2436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty