Provider Demographics
NPI:1114396959
Name:ADVANCED SLEEP TECHNOLOGY LLC
Entity Type:Organization
Organization Name:ADVANCED SLEEP TECHNOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSLYN
Authorized Official - Middle Name:CHERYL
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT, RST ,EMT
Authorized Official - Phone:201-981-7922
Mailing Address - Street 1:14 VOORHEES ST
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6214
Mailing Address - Country:US
Mailing Address - Phone:201-981-7922
Mailing Address - Fax:866-250-1660
Practice Address - Street 1:14 VOORHEES ST
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-6214
Practice Address - Country:US
Practice Address - Phone:201-981-7922
Practice Address - Fax:866-250-1660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QS1200X261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic