Healthcare Provider Details

I. General information

NPI: 1295266310
Provider Name (Legal Business Name): DELAWARE SLEEP DISORDER CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34434 KING STREET ROW SUITE 2
LEWES DE
19958-4787
US

IV. Provider business mailing address

252 CARTER DR SUITE 200
MIDDLETOWN DE
19709-5855
US

V. Phone/Fax

Practice location:
  • Phone: 302-449-7484
  • Fax: 302-376-8524
Mailing address:
  • Phone: 302-449-7484
  • Fax: 302-376-8524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LYRON A DEPUTY
Title or Position: CEO
Credential: APN
Phone: 302-449-7484