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General NPI Number Information
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NPI Number | 1619135902
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Entity Type | Organization
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Legal Business Name | SECOND HOME SLEEP LAB INC
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 1911 RICHMOND AVE STE 2102ND
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3913
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Country | US
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Telephone | 718-494-7769
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Fax | 718-494-7767
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Provider Business Mailing Address
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Address Line | 1911 RICHMOND AVE SUITE210, 2ND FLOOR
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City | STATEN ISLAND
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State | NY
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Zip | 10314
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Country | US
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Telephone | 718-494-7769
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Fax | 718-494-7767
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Authorized Official
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Title or Position | PRESIDENT
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Name | IGOR KATZ
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Credential |
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Telephone | 718-645-6434
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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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