Healthcare Provider Details

I. General information

NPI: 1548550213
Provider Name (Legal Business Name): CENTER FOR BETTER SLEEP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2598 3RD AVE
BRONX NY
10454-1118
US

IV. Provider business mailing address

205 3RD AVE SUITE 5J
NEW YORK NY
10003-2506
US

V. Phone/Fax

Practice location:
  • Phone: 917-664-3356
  • Fax:
Mailing address:
  • Phone: 917-664-3356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CRAIG LAWRENCE WILSON
Title or Position: PRESIDENT
Credential:
Phone: 917-664-3356