Provider Demographics
NPI:1669816054
Name:AMBOY SLEEP HEALTH CENTER INC.
Entity type:Organization
Organization Name:AMBOY SLEEP HEALTH CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-486-8602
Mailing Address - Street 1:235 NEW BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4146
Mailing Address - Country:US
Mailing Address - Phone:732-486-8602
Mailing Address - Fax:732-486-8517
Practice Address - Street 1:235 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4146
Practice Address - Country:US
Practice Address - Phone:732-486-8602
Practice Address - Fax:732-486-8517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ49FW00019600261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic