Provider Demographics
NPI:1164504999
Name:VECTOR SLEEP LLC
Entity Type:Organization
Organization Name:VECTOR SLEEP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VASSILI
Authorized Official - Middle Name:
Authorized Official - Last Name:KISSELEV
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:718-830-2800
Mailing Address - Street 1:6260 99 ST
Mailing Address - Street 2:UNIT #26
Mailing Address - City:REEGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1842
Mailing Address - Country:US
Mailing Address - Phone:718-830-2800
Mailing Address - Fax:718-830-2504
Practice Address - Street 1:6260 99 ST
Practice Address - Street 2:#26
Practice Address - City:REEGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1842
Practice Address - Country:US
Practice Address - Phone:718-830-2800
Practice Address - Fax:718-830-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7653773OtherAETNA
NY07170Medicare ID - Type Unspecified