Provider Demographics
NPI:1730560541
Name:SLEEPY HOLLOW HEALTH CARE SERVICES PLLC
Entity type:Organization
Organization Name:SLEEPY HOLLOW HEALTH CARE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MINNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-292-7334
Mailing Address - Street 1:1212 LINCOLNSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-2472
Mailing Address - Country:US
Mailing Address - Phone:989-292-7334
Mailing Address - Fax:
Practice Address - Street 1:1212 LINCOLNSHIRE DR
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-2472
Practice Address - Country:US
Practice Address - Phone:989-292-7334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010846207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty