Healthcare Provider Details

I. General information

NPI: 1851803514
Provider Name (Legal Business Name): LV SLEEP SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2017
Last Update Date: 11/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 INDUSTRIAL DR UNIT 1
BETHLEHEM PA
18017-2160
US

IV. Provider business mailing address

2019 INDUSTRIAL DR UNIT 1
BETHLEHEM PA
18017-2160
US

V. Phone/Fax

Practice location:
  • Phone: 610-868-7601
  • Fax: 610-867-8128
Mailing address:
  • Phone: 610-751-3509
  • Fax: 610-867-8128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberDSO16246L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDSO16246L
License Number StatePA

VIII. Authorized Official

Name: MRS. LINDA SUSAN PETRILLO
Title or Position: CLINICAL ADMINISTRATOR
Credential:
Phone: 610-751-3509