Healthcare Provider Details

I. General information

NPI: 1003216763
Provider Name (Legal Business Name): BERKSHIRE SLEEP SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2014
Last Update Date: 09/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CHURCH ST SUITE 101
GREAT BARRINGTON MA
01230-1378
US

IV. Provider business mailing address

29 CHURCH ST SUITE 101
GREAT BARRINGTON MA
01230-1378
US

V. Phone/Fax

Practice location:
  • Phone: 413-528-4680
  • Fax:
Mailing address:
  • Phone: 413-528-4680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number15898
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. FREDERIC PHILIP HYMAN
Title or Position: OWNER
Credential: DDS
Phone: 413-528-4680