Healthcare Provider Details

I. General information

NPI: 1598775504
Provider Name (Legal Business Name): LONG ISLAND SLEEP ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 E PULASKI RD WEST WING
HUNTINGTON STATION NY
11746-1915
US

IV. Provider business mailing address

989 W JERICHO TPKE
SMITHTOWN NY
11787-3203
US

V. Phone/Fax

Practice location:
  • Phone: 631-470-2544
  • Fax:
Mailing address:
  • Phone: 631-864-7100
  • Fax: 631-864-7129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL GUARINO
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 631-864-7100