MEDICARE: SLEEP-EZ DIAGNOSTIC SLEEP CENTERS, 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	207RS0012X	Sleep Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1649308396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP-EZ DIAGNOSTIC SLEEP CENTERS, LLC

Provider Business Mailing Address
First Line	:	1161 RED BIRD RD
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-7207
Country	:	US
Telephone Number	:	513-673-5039
Fax Number	:	513-791-3577

Provider Business Practice Location Address
First Line	:	9395 KENWOOD ROAD
Second Line	:	SUITE 101
City	:	CINCINNATI
State	:	OH
Zip	:	45242
Country	:	US
Telephone Number	:	513-673-5039
Fax Number	:	513-791-3577

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. RICHARD BRIAN BOSTER
Credential	:	MD
Telephone Number	:	513-673-5039

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	08/22/2020

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