Provider Demographics
NPI:1386969251
Name:GAYLORD SLEEP HEALTHCENTERS OF CONNECTICUT LLC
Entity type:Organization
Organization Name:GAYLORD SLEEP HEALTHCENTERS OF CONNECTICUT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FALKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-400-0044
Mailing Address - Street 1:277 SOUTH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-2731
Mailing Address - Country:US
Mailing Address - Phone:857-400-0044
Mailing Address - Fax:866-203-5459
Practice Address - Street 1:110 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1723
Practice Address - Country:US
Practice Address - Phone:617-999-9908
Practice Address - Fax:888-867-8844
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTERN PULMONARY SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-02
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT6572930001Medicare NSC