Provider Demographics
NPI:1740563659
Name:SLEEP MEDICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:SLEEP MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRABHAKARA
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:TUMPATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-946-5501
Mailing Address - Street 1:2632 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2907
Mailing Address - Country:US
Mailing Address - Phone:718-946-5501
Mailing Address - Fax:718-795-9408
Practice Address - Street 1:2632 E 21ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2907
Practice Address - Country:US
Practice Address - Phone:718-946-5501
Practice Address - Fax:718-795-9408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259009207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty