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NPI Code Detail

MEDICARE: OGNOMY SLEEP ASSOCIATES, NJ LLC

MEDICARE: OGNOMY SLEEP ASSOCIATES, NJ LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RS0012XSleep Medicine (Internal Medicine) Physician

General Provider Information

NPI Number : 1689378226
Entity Type Code : Organization
Provider Name (Legal Business Name) : OGNOMY SLEEP ASSOCIATES, NJ LLC
Provider Business Mailing Address
First Line : 640 ELLICOTT ST
Second Line :
City : BUFFALO
State : NY
Zip : 14203-1245
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5215 N IRONWOOD RD STE 202
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4908
Country : US
Telephone Number : 877-664-6669
Fax Number :
Authorized Official
Title or Position : CLINICAL OPERATIONS MANAGER
Name : SAMANTHA GLANZER
Credential :
Telephone Number : 701-367-4616
Provider Enumeration Date : 03/28/2023
Last Update Date : 03/28/2023

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