Provider Demographics
NPI:1912216573
Name:PERSANTE SLEEP CARE, INC.
Entity Type:Organization
Organization Name:PERSANTE SLEEP CARE, INC.
Other - Org Name:PERSANTE SLEEP CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PROBASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-753-3779
Mailing Address - Street 1:130 GAITHER DRIVE STE 124
Mailing Address - Street 2:
Mailing Address - City:MT. LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1715
Mailing Address - Country:US
Mailing Address - Phone:800-753-3779
Mailing Address - Fax:856-234-5010
Practice Address - Street 1:ONE CENTURIAN DRIVE STE: 208
Practice Address - Street 2:ABBY MEDICAL CENTER
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2137
Practice Address - Country:US
Practice Address - Phone:800-753-3779
Practice Address - Fax:856-234-5010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty