Provider Demographics
NPI:1083010995
Name:ADJUA SNORING & SLEEP APNEA SERVICES
Entity Type:Organization
Organization Name:ADJUA SNORING & SLEEP APNEA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:VIVIAN
Authorized Official - Last Name:IRVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-329-5512
Mailing Address - Street 1:5201 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-1627
Mailing Address - Country:US
Mailing Address - Phone:215-329-5512
Mailing Address - Fax:215-329-0401
Practice Address - Street 1:5201 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19141-1627
Practice Address - Country:US
Practice Address - Phone:215-329-5512
Practice Address - Fax:215-329-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023289L332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies