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NPI Code Detail

MEDICARE: SLEEP DISORDERS CENTER OF WYOMING VALLEY, LLC

MEDICARE: SLEEP DISORDERS CENTER OF WYOMING VALLEY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory077098PA

General Provider Information

NPI Number : 1235118522
Entity Type Code : Organization
Provider Name (Legal Business Name) : SLEEP DISORDERS CENTER OF WYOMING VALLEY, LLC
Provider Business Mailing Address
First Line : 190 WELLES ST
Second Line : SUITE 116
City : FORTY FORT
State : PA
Zip : 18704-4968
Country : US
Telephone Number : 570-331-2651
Fax Number : 570-331-2653
Provider Business Practice Location Address
First Line : 190 WELLES ST
Second Line : SUITE 116
City : FORTY FORT
State : PA
Zip : 18704-4968
Country : US
Telephone Number : 570-331-2651
Fax Number : 570-331-2653
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOHN J DELLA ROSA
Credential : M.D.
Telephone Number : 570-331-2651
Provider Enumeration Date : 01/13/2006
Last Update Date : 08/22/2020

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Directions to “SLEEP DISORDERS CENTER OF WYOMING VALLEY, LLC ” Practice Location

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