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General NPI Number Information
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NPI Number | 1396859518
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Entity Type | Organization
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Legal Business Name | DIGITRACE CARE SERVICES INC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 1983 MARCUS AVE SUITE E-134
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1016
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Country | US
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Telephone | 516-326-0629
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Fax | 516-326-0516
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Provider Business Mailing Address
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Address Line | 200 CORPORATE PL SUITE 5B
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City | PEABODY
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State | MA
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Zip | 01960-3840
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Country | US
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Telephone | 978-536-7400
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Fax | 978-535-9757
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Authorized Official
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Title or Position | EVP CFO
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Name | MR. CARL R. IBERGER
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Credential |
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Telephone | 978-536-7400
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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 |
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License Number State |
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