Provider Demographics
NPI:1902081995
Name:GHALY SLEEP CENTER
Entity Type:Organization
Organization Name:GHALY SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUATTROCIOCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:CMIC
Authorized Official - Phone:585-749-8534
Mailing Address - Street 1:614 S SALINA ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3500
Mailing Address - Country:US
Mailing Address - Phone:315-425-0599
Mailing Address - Fax:
Practice Address - Street 1:614 S SALINA ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3500
Practice Address - Country:US
Practice Address - Phone:315-425-0599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA157465-012084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty