Provider Demographics
NPI:1477937993
Name:NORTH EASTERN SLEEP MASTERS LLC
Entity Type:Organization
Organization Name:NORTH EASTERN SLEEP MASTERS LLC
Other - Org Name:DENTAL SLEEPMASTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:POLIT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-208-5305
Mailing Address - Street 1:20 E END CTR
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6968
Mailing Address - Country:US
Mailing Address - Phone:570-208-5305
Mailing Address - Fax:570-208-5626
Practice Address - Street 1:20 E END CTR
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6968
Practice Address - Country:US
Practice Address - Phone:570-208-5305
Practice Address - Fax:570-208-5626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7258950002Medicare NSC