Provider Demographics
NPI:1750702452
Name:SLEEPLABCORP LLC
Entity type:Organization
Organization Name:SLEEPLABCORP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-401-8929
Mailing Address - Street 1:2715 SPANISH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-8134
Mailing Address - Country:US
Mailing Address - Phone:617-401-8929
Mailing Address - Fax:
Practice Address - Street 1:2715 SPANISH RIVER RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-8134
Practice Address - Country:US
Practice Address - Phone:617-401-8929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty