Provider Demographics
NPI:1740519826
Name:THE NEUROLOGICAL MEDICINE SLEEP LABORATORY
Entity type:Organization
Organization Name:THE NEUROLOGICAL MEDICINE SLEEP LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:LEAHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-982-7944
Mailing Address - Street 1:7500 HANOVER PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2010
Mailing Address - Country:US
Mailing Address - Phone:301-982-7944
Mailing Address - Fax:301-441-8696
Practice Address - Street 1:7500 HANOVER PARKWAY GREENBELT, MD 20770-2009
Practice Address - Street 2:SUITE 201
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-982-7944
Practice Address - Fax:301-441-8696
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEUROLOGICAL MEDICINE, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-12-18
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1654OtherCAREFIRST BCBS OF DC
MDH832NEOtherCAREFIRST BCBS OF MD
MD912931600Medicaid
MD912931600Medicaid