Healthcare Provider Details

I. General information

NPI: 1639431141
Provider Name (Legal Business Name): ECO MEDICAL AND SLEEP MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1927 WILLIAMSBRIDGE RD LOWER LEVEL
BRONX NY
10461-1604
US

IV. Provider business mailing address

1927 WILLIAMSBRIDGE RD LOWER LEVEL
BRONX NY
10461-1604
US

V. Phone/Fax

Practice location:
  • Phone: 718-828-1549
  • Fax: 718-828-5029
Mailing address:
  • Phone: 718-828-1549
  • Fax: 718-828-5029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. MARISOL APONTE
Title or Position: PRESIDENT
Credential:
Phone: 718-828-1549