Provider Demographics
NPI:1598762106
Name:TOLLGATE SLEEP DISORDERS CENTER, INC.
Entity Type:Organization
Organization Name:TOLLGATE SLEEP DISORDERS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RCP
Authorized Official - Phone:401-737-4115
Mailing Address - Street 1:400 BALD HILL RD
Mailing Address - Street 2:SUITE 529
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1617
Mailing Address - Country:US
Mailing Address - Phone:401-737-4115
Mailing Address - Fax:401-737-4347
Practice Address - Street 1:400 BALD HILL RD
Practice Address - Street 2:SUITE 529
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1617
Practice Address - Country:US
Practice Address - Phone:401-737-4115
Practice Address - Fax:401-737-4347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRCP00377261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic