Healthcare Provider Details

I. General information

NPI: 1770887739
Provider Name (Legal Business Name): SLEEP HEALTHCARE OF CT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2011
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 POST RD. SUITE 305
FAIRFIELD CT
06824
US

IV. Provider business mailing address

1305 POST RD. SUITE 305
FAIRFIELD CT
06824
US

V. Phone/Fax

Practice location:
  • Phone: 203-292-9800
  • Fax: 203-292-9799
Mailing address:
  • Phone: 203-292-9800
  • Fax: 203-292-9799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number14245
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. A. JOEL PAPOWITZ
Title or Position: OWNER
Credential: M. D.
Phone: 203-292-9800