Provider Demographics
NPI:1972857266
Name:SLEEP DIAGNOSTIC & RESEARCH OF ARIZONA
Entity type:Organization
Organization Name:SLEEP DIAGNOSTIC & RESEARCH OF ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLEEP TECHNOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:DEMETRE
Authorized Official - Last Name:SIRAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:520-904-8655
Mailing Address - Street 1:4558 N 1ST AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5666
Mailing Address - Country:US
Mailing Address - Phone:520-398-7455
Mailing Address - Fax:520-344-8797
Practice Address - Street 1:4558 N 1ST AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5666
Practice Address - Country:US
Practice Address - Phone:520-398-7455
Practice Address - Fax:520-344-8797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic