Organization
VECTOR SLEEP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VASSILI KISSELEV RT (PRESIDENT)
(718) 830-2800
Entity
Organization
Contact information
Practice address
6260 99 ST, #26, REEGO PARK, NY 11374-1842
(718) 830-2800
(718) 830-2504
Mailing address
6260 99 ST, UNIT #26, REEGO PARK, NY 11374-1842
(718) 830-2800
(718) 830-2504
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7653773
AETNA
NY
Enumeration date
10/20/2006
Last updated
08/22/2020
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