Provider Demographics
NPI:1538473020
Name:HACKENSACK SLEEP INSTITUTE, LLC
Entity Type:Organization
Organization Name:HACKENSACK SLEEP INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIBORZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHTYANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-996-0170
Mailing Address - Street 1:170 PROSPECT AVENUE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:201-996-0170
Mailing Address - Fax:201-996-0095
Practice Address - Street 1:170 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1820
Practice Address - Country:US
Practice Address - Phone:201-996-0170
Practice Address - Fax:201-996-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1438770174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty