Provider Demographics
NPI:1528316098
Name:INDEPENDANT SLEEP DIAGNOSTICS LLC
Entity type:Organization
Organization Name:INDEPENDANT SLEEP DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:HUMMEL
Authorized Official - Suffix:III
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:855-777-3211
Mailing Address - Street 1:PO BOX 1207
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19903-1207
Mailing Address - Country:US
Mailing Address - Phone:855-777-3211
Mailing Address - Fax:302-647-4168
Practice Address - Street 1:201 TEA PARTY TRL
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-8881
Practice Address - Country:US
Practice Address - Phone:855-777-3211
Practice Address - Fax:302-647-4168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic