1134143654 NPI number — ADVANCED SLEEP NEURODIAGNOSTICS, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134143654 NPI number — ADVANCED SLEEP NEURODIAGNOSTICS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED SLEEP NEURODIAGNOSTICS, PC
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:
1134143654
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24001 ORCHARD LAKE RD
Provider Second Line Business Mailing Address:
SUITE #140
Provider Business Mailing Address City Name:
FARMINGTON HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48336-2555
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-442-3700
Provider Business Mailing Address Fax Number:
248-442-8860

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24001 ORCHARD LAKE RD
Provider Second Line Business Practice Location Address:
SUITE #140
Provider Business Practice Location Address City Name:
FARMINGTON HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48336-2555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-442-3700
Provider Business Practice Location Address Fax Number:
248-442-8860
Provider Enumeration Date:
07/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ZAHOOR
Authorized Official First Name:
MOHAMMED
Authorized Official Middle Name:
I.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
248-442-3700

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X , with the licence number:  4301062300 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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