Healthcare Provider Details

I. General information

NPI: 1043258841
Provider Name (Legal Business Name): SLEEP DISORDER ASSOCIATES OF LANCASTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 06/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 RANCK AVE
LANCASTER PA
17602-2516
US

IV. Provider business mailing address

250 RANCK AVE
LANCASTER PA
17602-2516
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-7044
  • Fax: 717-431-9684
Mailing address:
  • Phone: 717-569-7044
  • Fax: 717-431-9684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS-011844
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NEIL S. KLINE
Title or Position: CEO
Credential: D.O.
Phone: 717-569-7044