Healthcare Provider Details

I. General information

NPI: 1750683140
Provider Name (Legal Business Name): KIDS SLEEP MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 ROSE PL SUITE A
NEW HYDE PARK NY
11040-5312
US

IV. Provider business mailing address

50 ROSE PL SUITE A
NEW HYDE PARK NY
11040-5312
US

V. Phone/Fax

Practice location:
  • Phone: 866-711-1299
  • Fax: 888-539-3001
Mailing address:
  • Phone: 866-711-1299
  • Fax: 888-539-3001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number2897
License Number StateNY

VIII. Authorized Official

Name: DR. CATHERINE KIER
Title or Position: OWNER
Credential: M.D.
Phone: 866-711-1299