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General NPI Number Information
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NPI Number | 1811441645
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Entity Type | Organization
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Legal Business Name | INNOVATIVE SLEEP DIAGNOSTIC SERVICES LLC
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 217 WALNUT STREET UNIT B
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City | METAIRIE
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State | LA
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Zip | 70005
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Country | US
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Telephone | 504-833-4844
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Fax | 504-833-4336
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Provider Business Mailing Address
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Address Line | PO BOX 55101
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City | METAIRIE
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State | LA
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Zip | 70055
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Country | US
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Telephone | 504-833-4844
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Fax | 504-833-4336
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Authorized Official
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Title or Position | CEO
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Name | STEVEN GERARD GUILLOTTE
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Credential |
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Telephone | 504-833-4844
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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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