Provider Demographics
NPI:1487601944
Name:PEAK RESPIRATORY & SLEEP INC
Entity type:Organization
Organization Name:PEAK RESPIRATORY & SLEEP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTSAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-455-3030
Mailing Address - Street 1:120 WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1927
Mailing Address - Country:US
Mailing Address - Phone:732-455-3030
Mailing Address - Fax:856-547-1336
Practice Address - Street 1:120 WHITE HORSE PIKE
Practice Address - Street 2:SUITE 105
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1927
Practice Address - Country:US
Practice Address - Phone:732-455-3030
Practice Address - Fax:856-547-1336
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BBMK ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-30
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAYM-004575-L332B00000X, 332BX2000X
NJ43ZA00296400332BX2000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0105473Medicaid
PA0124820601Medicaid
PA0124820601Medicaid