Provider Demographics
NPI:1063704328
Name:SLEEP SERVICES OF MARYLAND, L.L.C.
Entity type:Organization
Organization Name:SLEEP SERVICES OF MARYLAND, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YASH
Authorized Official - Middle Name:PAL
Authorized Official - Last Name:MEHNDIRATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-994-6655
Mailing Address - Street 1:20032 NORTHVILLE HILLS TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-7020
Mailing Address - Country:US
Mailing Address - Phone:703-994-6655
Mailing Address - Fax:571-291-2752
Practice Address - Street 1:15200 SHADY GROVE RD
Practice Address - Street 2:SUITE 401
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3218
Practice Address - Country:US
Practice Address - Phone:703-994-6655
Practice Address - Fax:571-291-2752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00468102084N0400X, 2084S0012X
MDD00583162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty