Healthcare Provider Details

I. General information

NPI: 1710750625
Provider Name (Legal Business Name): SLEEP SERVICES FOR THE AUTISTIC COMMUNITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 INTERNATIONAL DR STE 100
WILLIAMSVILLE NY
14221-5783
US

IV. Provider business mailing address

941 MCLEAN AVE STE 370
YONKERS NY
10704-4107
US

V. Phone/Fax

Practice location:
  • Phone: 716-577-4501
  • Fax:
Mailing address:
  • Phone: 914-639-2445
  • Fax: 914-639-2442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: FRANCISCO MONEGRO
Title or Position: DIRECTOR
Credential: PHD, MD
Phone: 914-639-2445