Provider Demographics
NPI:1497705792
Name:ATLANTIC SLEEP DIAGNOSTIC AND TREATMENT CENTERS LLC
Entity type:Organization
Organization Name:ATLANTIC SLEEP DIAGNOSTIC AND TREATMENT CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-776-1025
Mailing Address - Street 1:19 FIELD STREET
Mailing Address - Street 2:
Mailing Address - City:KANE
Mailing Address - State:PA
Mailing Address - Zip Code:16735
Mailing Address - Country:US
Mailing Address - Phone:814-837-8490
Mailing Address - Fax:814-837-8493
Practice Address - Street 1:19 FIELD STREET
Practice Address - Street 2:
Practice Address - City:KANE
Practice Address - State:PA
Practice Address - Zip Code:16735
Practice Address - Country:US
Practice Address - Phone:814-837-8490
Practice Address - Fax:814-837-8493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic