Provider Demographics
NPI:1699756411
Name:ADVANTAGE SLEEP CENTERS LLC
Entity type:Organization
Organization Name:ADVANTAGE SLEEP CENTERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSGOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-424-2000
Mailing Address - Street 1:1998 ROUTE 70 E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1834
Mailing Address - Country:US
Mailing Address - Phone:856-424-2000
Mailing Address - Fax:856-424-2007
Practice Address - Street 1:1998 ROUTE 70 E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1834
Practice Address - Country:US
Practice Address - Phone:856-424-2000
Practice Address - Fax:856-424-2007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23307246Z00000X, 261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ122123Medicare Oscar/Certification