Provider Demographics
NPI:1700306321
Name:EMPIRE SLEEP MEDICINE, PLLC
Entity Type:Organization
Organization Name:EMPIRE SLEEP MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SURKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-902-5678
Mailing Address - Street 1:1862 OLD FORT RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-9373
Mailing Address - Country:US
Mailing Address - Phone:252-902-5678
Mailing Address - Fax:
Practice Address - Street 1:147 W 116TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-2521
Practice Address - Country:US
Practice Address - Phone:212-380-7960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-24
Last Update Date:2017-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284359207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty