Healthcare Provider Details

I. General information

NPI: 1659763522
Provider Name (Legal Business Name): SLEEP MANAGEMENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 CHERRY ST SUITE A
MILFORD CT
06460-3503
US

IV. Provider business mailing address

255 CHERRY ST SUITE A
MILFORD CT
06460-3503
US

V. Phone/Fax

Practice location:
  • Phone: 203-931-3050
  • Fax:
Mailing address:
  • Phone: 203-931-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number006676
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number006676
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number006676
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number006676
License Number StateCT

VIII. Authorized Official

Name: JOSEPH DAVID TARTAGNI
Title or Position: PRESIDENT
Credential: DMD
Phone: 203-931-3050