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General NPI Number Information
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NPI Number | 1912421918
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Entity Type | Organization
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Legal Business Name | TWIN COUNTY SLEEP CENTER LLC
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | TWIN COUNTY SLEEP CENTER, 2 SHERMAN POTTS DR STE 201
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City | GHENT
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State | NY
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Zip | 12075-3216
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Country | US
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Telephone | 518-633-4464
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Fax | 518-633-4469
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Provider Business Mailing Address
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Address Line | 46 QUAIL LN
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City | TIVOLI
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State | NY
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Zip | 12583-5007
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Country | US
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Telephone | 518-965-8956
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Fax |
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Authorized Official
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Title or Position | FACILITY ADMINISTRATOR
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Name | DR. VINITA GUPTA
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Credential | MD
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Telephone | 518-965-8956
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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 | 197319
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License Number State | NY
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