1225084205 NPI number — SLEEP MANAGEMENT SOLUTIONS LLC

Table of content: (NPI 1225084205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225084205 NPI number — SLEEP MANAGEMENT SOLUTIONS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLEEP MANAGEMENT SOLUTIONS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225084205
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 KENNY ROBERTS MEMORIAL DR
Provider Second Line Business Mailing Address:
UNIT 2
Provider Business Mailing Address City Name:
SUFFIELD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06078-2500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-668-0534
Provider Business Mailing Address Fax Number:
860-668-7487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 KENNY ROBERTS MEMORIAL DR
Provider Second Line Business Practice Location Address:
UNIT 2
Provider Business Practice Location Address City Name:
SUFFIELD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06078-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-668-0534
Provider Business Practice Location Address Fax Number:
860-668-7487
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GAFFNEY
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
PATRICK
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
860-668-0534

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com