Provider Demographics
NPI:1972865376
Name:ADVANTAGE SLEEP ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ADVANTAGE SLEEP ASSOCIATES, LLC
Other - Org Name:ADVANTAGE SLEEP CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOBITHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-424-2000
Mailing Address - Street 1:1998 ROUTE 70 E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1834
Mailing Address - Country:US
Mailing Address - Phone:856-424-2000
Mailing Address - Fax:856-424-2007
Practice Address - Street 1:2301 E EVESHAM RD
Practice Address - Street 2:SUITE 603 AND 604
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4501
Practice Address - Country:US
Practice Address - Phone:856-772-1119
Practice Address - Fax:856-772-1129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24516261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic