Organization
BIOSERENITY DT INC.
Active
Other names
SleepMed
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN RUSSELL (CFO)
(770) 330-7836
Entity
Organization
Contact information
Practice address
13662 OFFICE PL, SUITE 104, WOODBRIDGE, VA 22192-4217
(703) 580-4679
Mailing address
200 CORPORATE PL, SUITE 5B, PEABODY, MA 01960-3840
(978) 536-7400
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FVS029
MEDICARE
MD
Enumeration date
07/21/2010
Last updated
11/04/2021
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