Provider Demographics
NPI:1295109254
Name:DELAWARE SLEEP DISORDER CENTERS, LLC
Entity type:Organization
Organization Name:DELAWARE SLEEP DISORDER CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYRON
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEPUTY
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:302-449-7484
Mailing Address - Street 1:252 CARTER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-5855
Mailing Address - Country:US
Mailing Address - Phone:302-449-7484
Mailing Address - Fax:
Practice Address - Street 1:20930 DUPONT BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-1725
Practice Address - Country:US
Practice Address - Phone:302-449-7484
Practice Address - Fax:302-376-8524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE20151109122261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic