Provider Demographics
NPI:1932288214
Name:GEAUGA SLEEP CENTER
Entity Type:Organization
Organization Name:GEAUGA SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-285-9598
Mailing Address - Street 1:13221 RAVENNA RD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9047
Mailing Address - Country:US
Mailing Address - Phone:440-285-9598
Mailing Address - Fax:
Practice Address - Street 1:13221 RAVENNA RD
Practice Address - Street 2:SUITE 13
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9047
Practice Address - Country:US
Practice Address - Phone:440-285-9598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-0889-D174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty