Provider Demographics
NPI:1356511554
Name:COMMONWEALTH SLEEP CENTER, LLC
Entity Type:Organization
Organization Name:COMMONWEALTH SLEEP CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANJEEV
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-448-0488
Mailing Address - Street 1:7001 HERITAGE VILLAGE PLAZA UNIT 120
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20115
Mailing Address - Country:US
Mailing Address - Phone:703-448-0488
Mailing Address - Fax:703-492-2400
Practice Address - Street 1:7001 HERITAGE VILLAGE PLAZA
Practice Address - Street 2:120
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:703-448-0488
Practice Address - Fax:703-492-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty