Organization
BIOSERENITY DT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE SHOCK (EVP CLINICAL OPERATIONS)
(214) 532-3757
Entity
Organization
Contact information
Practice address
130 S STATE RD STE 202, SPRINGFIELD, PA 19064-1232
(610) 543-6800
(610) 543-8051
Mailing address
99 ROSEWOOD DR STE 245, DANVERS, MA 01923-4537
(978) 536-7400
(978) 535-9778
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0453320000
AMERIHEALTH PERS CHOICE
PA
01
—
0658107000
KEYSTONE
PA
01
—
7618325
AETNA
PA
Enumeration date
08/12/2006
Last updated
05/10/2022
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