Provider Demographics
NPI:1417199100
Name:SLEEP LAB LLC
Entity Type:Organization
Organization Name:SLEEP LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORLOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-945-2900
Mailing Address - Street 1:596 ANDERSON AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-1831
Mailing Address - Country:US
Mailing Address - Phone:201-945-2900
Mailing Address - Fax:201-945-2905
Practice Address - Street 1:596 ANDERSON AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-1831
Practice Address - Country:US
Practice Address - Phone:201-945-2900
Practice Address - Fax:201-945-2905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0448032080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty