Organization
DIAGNOSTIC SLEEP LAB CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IMRAN M BAJWA MD (DIRECTOR)
(814) 419-1055
Entity
Organization
Contact information
Practice address
50 VISTA DR, INDIANA, PA 15701-2210
(814) 419-1055
Mailing address
50 VISTA DR, INDIANA, PA 15701-2210
(814) 419-1055
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD052043L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016850710001
—
PA
01
—
1872894
BCBS
PA
Enumeration date
11/13/2006
Last updated
08/22/2020
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