Provider Demographics
NPI:1578704995
Name:PUNXSUTAWNEY SLEEP CENTER
Entity Type:Organization
Organization Name:PUNXSUTAWNEY SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MUNIR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-589-6904
Mailing Address - Street 1:214 W MAHONING ST
Mailing Address - Street 2:FIRST FLOOR FRONT
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-1940
Mailing Address - Country:US
Mailing Address - Phone:814-618-2064
Mailing Address - Fax:888-789-1480
Practice Address - Street 1:214 W MAHONING ST
Practice Address - Street 2:FIRST FLOOR FRONT
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-1940
Practice Address - Country:US
Practice Address - Phone:814-618-2064
Practice Address - Fax:888-789-1480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-14
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023292210001Medicaid