MEDICARE: ISLEEP-USA, 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
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1578940052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISLEEP-USA, LLC

Provider Business Mailing Address
First Line	:	1925 ADAM CLAYTON POWELL JUNIOR BOULEVARD
Second Line	:	SUITE 1-I
City	:	NEW YORK
State	:	NY
Zip	:	10026-2225
Country	:	US
Telephone Number	:	855-646-3700
Fax Number	:	855-646-3737

Provider Business Practice Location Address
First Line	:	1925 ADAM CLAYTON POWELL JUNIOR BOULEVARD
Second Line	:	SUITE 1-I
City	:	NEW YORK
State	:	NY
Zip	:	10026-2225
Country	:	US
Telephone Number	:	855-646-3700
Fax Number	:	855-646-3737

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DIMITRY KARGMEN
Credential	:
Telephone Number	:	855-646-3700

Provider Enumeration Date	:	05/04/2015
Last Update Date	:	08/31/2015

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Directions to “ISLEEP-USA, LLC ” Practice Location

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