Provider Demographics
NPI:1992015622
Name:SLEEP MEDICINE AND NEUROLOGY, PLLC
Entity Type:Organization
Organization Name:SLEEP MEDICINE AND NEUROLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:KEMERKO
Authorized Official - Last Name:SESI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-755-4913
Mailing Address - Street 1:2545 CEDAR BROOK COURT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309
Mailing Address - Country:US
Mailing Address - Phone:248-755-4913
Mailing Address - Fax:
Practice Address - Street 1:217 S HURON ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-1919
Practice Address - Country:US
Practice Address - Phone:231-627-7327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010164432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty