Provider Demographics
NPI:1508171224
Name:SLEEPHUB AT VERONA LLC
Entity Type:Organization
Organization Name:SLEEPHUB AT VERONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-571-0200
Mailing Address - Street 1:96 POMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2917
Mailing Address - Country:US
Mailing Address - Phone:973-571-0200
Mailing Address - Fax:
Practice Address - Street 1:96 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2917
Practice Address - Country:US
Practice Address - Phone:973-571-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB53988261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6171001Medicaid
NJF81293Medicare UPIN
NJ6171001Medicaid
NJF81293Medicare UPIN