Healthcare Provider Details

I. General information

NPI: 1699756411
Provider Name (Legal Business Name): ADVANTAGE SLEEP CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1998 ROUTE 70 E
CHERRY HILL NJ
08003-1834
US

IV. Provider business mailing address

1998 ROUTE 70 E
CHERRY HILL NJ
08003-1834
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-2000
  • Fax: 856-424-2007
Mailing address:
  • Phone: 856-424-2000
  • Fax: 856-424-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number23307
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number23307
License Number StateNJ

VIII. Authorized Official

Name: MR. BRETT MOSGOWSKY
Title or Position: OWNER
Credential:
Phone: 856-424-2000