Provider Demographics
NPI:1871205302
Name:DELAWARE SLEEP DISORDER CENTERS
Entity type:Organization
Organization Name:DELAWARE SLEEP DISORDER CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYRON
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:DEPUTY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:302-652-5109
Mailing Address - Street 1:620 STANTON CHRISTIANA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2134
Mailing Address - Country:US
Mailing Address - Phone:302-449-7484
Mailing Address - Fax:
Practice Address - Street 1:111 NEUROLOGY WAY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-5368
Practice Address - Country:US
Practice Address - Phone:302-449-7484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic