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General NPI Number Information
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NPI Number | 1437434925
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Entity Type | Organization
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Legal Business Name | CITYWIDE C SLEEP CENTER LLC
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Dates
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Enumeration Date | 10/15/2011
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Last Update Date | 10/15/2011
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Provider Practice Location Address
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Address Line | 25012 HILLSIDE AVE STE B
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City | BELLEROSE
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State | NY
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Zip | 11426-2139
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Country | US
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Telephone | 718-347-0411
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Fax | 718-347-0455
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Provider Business Mailing Address
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Address Line | 250-12 B HILLSIDE AVE
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City | BELLEROSE
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State | NY
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Zip | 11426
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Country | US
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Telephone | 718-347-0411
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Fax | 718-347-0455
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Authorized Official
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Title or Position | MD FCCP
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Name | DR. SANDEEP MEHRISHI
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Credential |
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Telephone | 718-347-0411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 00125061
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 00125061
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License Number State | NY
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