Provider Demographics
NPI:1326224973
Name:NORTHEAST INSOMNIA & SLEEP CENTER LLC
Entity Type:Organization
Organization Name:NORTHEAST INSOMNIA & SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABDEL-FADIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-936-0066
Mailing Address - Street 1:68 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1656
Mailing Address - Country:US
Mailing Address - Phone:732-936-0066
Mailing Address - Fax:732-936-9998
Practice Address - Street 1:68 WHITE ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1656
Practice Address - Country:US
Practice Address - Phone:732-936-0066
Practice Address - Fax:732-936-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RC0200X, 207RS0012X
NJ25MA08294600207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty