Healthcare Provider Details

I. General information

NPI: 1235318676
Provider Name (Legal Business Name): SLEEP FOR HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 W JIMMIE LEEDS RD SUITE 402A
GALLOWAY NJ
08205
US

IV. Provider business mailing address

1500 S LINCOLN AVE
VINELAND NJ
08361
US

V. Phone/Fax

Practice location:
  • Phone: 609-652-2255
  • Fax: 888-778-6731
Mailing address:
  • Phone: 856-691-2553
  • Fax: 856-691-3370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number24202
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: LISA MAZZONE
Title or Position: PRESIDENT
Credential:
Phone: 609-751-0425