Healthcare Provider Details

I. General information

NPI: 1366542250
Provider Name (Legal Business Name): SLEEP CENTER INTERPRETATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 BROAD RD COMMUNITY GENERAL HOSPITAL
SYRACUSE NY
13215-2265
US

IV. Provider business mailing address

1001 W FAYETTE ST SUITE 400
SYRACUSE NY
13204-2859
US

V. Phone/Fax

Practice location:
  • Phone: 315-472-1488
  • Fax: 315-492-5521
Mailing address:
  • Phone: 315-472-1488
  • Fax: 315-472-8060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT E. WESTLAKE
Title or Position: PHYSICIAN/ PARTNER
Credential: MD
Phone: 315-472-1488