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General NPI Number Information
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NPI Number | 1821906660
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Entity Type | Organization
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Legal Business Name | DAYSTROM LABS, LLC
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 103 W LEGION ST
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City | WHITEHALL
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State | MT
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Zip | 59759-9735
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Country | US
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Telephone | 646-893-4309
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Fax | 332-334-3008
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Provider Business Mailing Address
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Address Line | 80 8TH AVE STE 202
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City | NEW YORK
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State | NY
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Zip | 10011-0607
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Country | US
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Telephone | 646-893-4309
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Fax | 332-334-3008
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Authorized Official
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Title or Position | OWNER
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Name | RYAN SULTAN
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Credential | MD
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Telephone | 646-893-4309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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