Provider Demographics
NPI:1124158662
Name:ARLINGTON SLEEP MEDICINE, LTD.
Entity type:Organization
Organization Name:ARLINGTON SLEEP MEDICINE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOFREED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-243-6700
Mailing Address - Street 1:3833 FAIRFAX DR
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1772
Mailing Address - Country:US
Mailing Address - Phone:703-243-6700
Mailing Address - Fax:703-243-3131
Practice Address - Street 1:3833 FAIRFAX DR
Practice Address - Street 2:SUITE 360
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1772
Practice Address - Country:US
Practice Address - Phone:703-243-6700
Practice Address - Fax:703-243-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101036617174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1982792420OtherNPI
VAB94205Medicare UPIN
DCG02635A01Medicare PIN
DC1982792420OtherNPI