Provider Demographics
NPI:1104378090
Name:SLEEP DIAGNOSTICS INC
Entity Type:Organization
Organization Name:SLEEP DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PURVI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUKLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-385-1892
Mailing Address - Street 1:1188 WILLIS AVE
Mailing Address - Street 2:SUITE # 828
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1229
Mailing Address - Country:US
Mailing Address - Phone:516-385-1892
Mailing Address - Fax:516-385-4150
Practice Address - Street 1:50 E 42ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5405
Practice Address - Country:US
Practice Address - Phone:516-385-1892
Practice Address - Fax:516-385-4150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization