Healthcare Provider Details
I. General information
NPI: 1649203399
Provider Name (Legal Business Name): SOMNOGRAPH, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1800 LOMBARD ST SUITE 100
PHILADELPHIA PA
19146-8400
US
IV. Provider business mailing address
1841 N ROCK ROAD CT SUITE 100
WICHITA KS
67206-4202
US
V. Phone/Fax
- Phone: 215-893-2424
- Fax: 215-893-7220
- Phone: 316-616-6160
- Fax: 316-616-6161
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DUKE
C
NAIPOHN
Title or Position: OWNER/CEO
Credential:
Phone: 316-683-2323