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General NPI Number Information
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NPI Number | 1518476985
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Entity Type | Organization
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Legal Business Name | PARK SLEEP VIP & WELLNESS LLC
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 67 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10016-2557
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Country | US
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Telephone | 718-684-6393
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Fax | 718-684-6995
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Provider Business Mailing Address
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Address Line | 2102 BAY RIDGE PKWY
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City | BROOKLYN
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State | NY
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Zip | 11204-5945
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Country | US
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Telephone | 718-684-6393
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Fax | 718-684-6395
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | DR. STEVE SLOBOSKI
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Credential | DDS
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Telephone | 718-684-6393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | 234613
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 234613
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 234613
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License Number State | NY
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