Provider Demographics
NPI:1972093342
Name:GOOD KNIGHTS SLEEP CENTER, LLC
Entity type:Organization
Organization Name:GOOD KNIGHTS SLEEP CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:158-841-5952
Mailing Address - Street 1:2217 MOUNT CARMEL AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-4709
Mailing Address - Country:US
Mailing Address - Phone:215-884-1595
Mailing Address - Fax:215-884-3947
Practice Address - Street 1:2217 MOUNT CARMEL AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-4709
Practice Address - Country:US
Practice Address - Phone:215-884-1595
Practice Address - Fax:215-884-3947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment