Provider Demographics
NPI:1891994042
Name:SLEEP MEDICINE SERVICES OF WESTERN MASSACHUSETTS LLC
Entity Type:Organization
Organization Name:SLEEP MEDICINE SERVICES OF WESTERN MASSACHUSETTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-253-2767
Mailing Address - Street 1:3640 MAIN ST STE 208
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1192
Mailing Address - Country:US
Mailing Address - Phone:413-253-2767
Mailing Address - Fax:413-253-9767
Practice Address - Street 1:3640 MAIN ST STE 208
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1192
Practice Address - Country:US
Practice Address - Phone:413-253-2767
Practice Address - Fax:413-253-9767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QS1200X
261QS1200X
MA80036332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASF040869OtherBCBS
MA811114OtherTUFTS