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General NPI Number Information
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NPI Number | 1003853540
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Entity Type | Organization
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Legal Business Name | DELMARVA SLEEP DIAGNOSTICS, INC.
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 104 SLEEPY HOLLOW DR SUITE 203
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City | MIDDLETOWN
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State | DE
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Zip | 19709-8894
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Country | US
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Telephone | 302-449-5460
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Fax | 302-449-5475
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Provider Business Mailing Address
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Address Line | 104 SLEEPY HOLLOW DR SUITE 203
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City | MIDDLETOWN
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State | DE
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Zip | 19709-8894
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Country | US
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Telephone | 302-449-5460
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Fax | 302-449-5475
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. DAVID ANTHONY GODLEWSKI
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Credential |
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Telephone | 302-449-5460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 2004206616
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License Number State | DE
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