Provider Demographics
NPI:1659633469
Name:THE INSOMNIA AND SLEEP INSTITUTE OF ARIZONA LLC
Entity Type:Organization
Organization Name:THE INSOMNIA AND SLEEP INSTITUTE OF ARIZONA LLC
Other - Org Name:HEADACHE AND EPILEPSY INSTITUTE OF ARIZONA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR AND MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUCHIR
Authorized Official - Middle Name:PRAVIN
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-745-3547
Mailing Address - Street 1:8330 E HARTFORD DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7205
Mailing Address - Country:US
Mailing Address - Phone:480-745-3547
Mailing Address - Fax:480-745-3548
Practice Address - Street 1:8330 E HARTFORD DR
Practice Address - Street 2:STE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7205
Practice Address - Country:US
Practice Address - Phone:480-745-3547
Practice Address - Fax:480-745-3548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ709411Medicaid
AZZ93347Medicare PIN