Provider Demographics
NPI:1306901384
Name:SOUTHAMPTON SLEEP DISORDER CENTER, INC.
Entity type:Organization
Organization Name:SOUTHAMPTON SLEEP DISORDER CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:GIUGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:631-287-9690
Mailing Address - Street 1:335D MEETING HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-5051
Mailing Address - Country:US
Mailing Address - Phone:631-287-9690
Mailing Address - Fax:631-287-9691
Practice Address - Street 1:335D MEETING HOUSE LN
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5051
Practice Address - Country:US
Practice Address - Phone:631-287-9690
Practice Address - Fax:631-287-9691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97Z521Medicare ID - Type UnspecifiedSLEEP DISORDER CENTER