Provider Demographics
NPI:1619186863
Name:SLEEP DIAGNOSTICS OF N.Y., INC.
Entity Type:Organization
Organization Name:SLEEP DIAGNOSTICS OF N.Y., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLEEP LAB MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:GANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-575-3300
Mailing Address - Street 1:11034 70TH RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3934
Mailing Address - Country:US
Mailing Address - Phone:718-575-3300
Mailing Address - Fax:
Practice Address - Street 1:11034 70TH RD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3934
Practice Address - Country:US
Practice Address - Phone:718-575-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Single Specialty