Healthcare Provider Details

I. General information

NPI: 1457761892
Provider Name (Legal Business Name): AT HOME SLEEP SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26-07 BROADWAY
FAIR LAWN NJ
07410
US

IV. Provider business mailing address

26-07 BROADWAY
FAIR LAWN NJ
07410
US

V. Phone/Fax

Practice location:
  • Phone: 201-396-9338
  • Fax:
Mailing address:
  • Phone: 201-396-9338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MICHAEL DOBLIN
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 201-396-9338