1639406044 NPI number — CONNECTICUT SLEEP MEDICINE, LLC

Table of content: (NPI 1639406044)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639406044 NPI number — CONNECTICUT SLEEP MEDICINE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONNECTICUT SLEEP MEDICINE, 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:
1639406044
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4131
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YALESVILLE
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06492-1481
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-284-1340
Provider Business Mailing Address Fax Number:
203-265-4557

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
61 POMEROY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERIDEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06450-7101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-694-8760
Provider Business Practice Location Address Fax Number:
203-265-4557
Provider Enumeration Date:
11/05/2009

Additional Information

Authorized Official

Authorized Official Last Name:
VOLPE
Authorized Official First Name:
BRETT
Authorized Official Middle Name:
T
Authorized Official Title or Position:
SOLE MEMBER
Authorized Official Telephone Number:
20328413401

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RS0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com