Provider Demographics
NPI:1508952987
Name:SLEEP PROFESSIONALS, INC.
Entity Type:Organization
Organization Name:SLEEP PROFESSIONALS, INC.
Other - Org Name:IGOR KHELEMSKY, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARYASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-945-2905
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:2006-10-05
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ801063Medicare ID - Type Unspecified
NYW7Z321Medicare ID - Type Unspecified