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General NPI Number Information
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NPI Number | 1700306321
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Entity Type | Organization
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Legal Business Name | EMPIRE SLEEP MEDICINE, PLLC
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Dates
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Enumeration Date | 06/24/2017
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Last Update Date | 06/24/2017
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Provider Practice Location Address
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Address Line | 147 W 116TH ST
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City | NEW YORK
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State | NY
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Zip | 10026-2521
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Country | US
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Telephone | 212-380-7960
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Fax |
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Provider Business Mailing Address
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Address Line | 1862 OLD FORT RD
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City | GREENVILLE
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State | NC
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Zip | 27834-9373
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Country | US
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Telephone | 252-902-5678
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEE A SURKIN
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Credential | MD
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Telephone | 252-902-5678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 284359
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License Number State | NY
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