Healthcare Provider Details

I. General information

NPI: 1033859822
Provider Name (Legal Business Name): BLUESLEEP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 5TH AVE 3RD FL
NEW YORK NY
10016
US

IV. Provider business mailing address

169 MADISON AVE STE 15025
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 212-683-0174
  • Fax: 646-731-6880
Mailing address:
  • Phone: 212-683-0174
  • Fax: 646-731-6880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JORDAN STERN
Title or Position: PRESIDENT
Credential: MD
Phone: 212-683-0174