Provider Demographics
NPI:1043258841
Name:SLEEP DISORDER ASSOCIATES OF LANCASTER, INC
Entity Type:Organization
Organization Name:SLEEP DISORDER ASSOCIATES OF LANCASTER, INC
Other - Org Name:SLEEP DISORDER ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-569-7044
Mailing Address - Street 1:250 RANCK AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2516
Mailing Address - Country:US
Mailing Address - Phone:717-569-7044
Mailing Address - Fax:717-431-9684
Practice Address - Street 1:250 RANCK AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2516
Practice Address - Country:US
Practice Address - Phone:717-569-7044
Practice Address - Fax:717-431-9684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-011844207R00000X
261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA050086Medicare ID - Type Unspecified