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
1003 EASTON RD, SUITE 101, WILLOW GROVE, PA 19090
(610) 543-6800
Mailing address
99 ROSEWOOD DR STE 245, DANVERS, MA 01923-4537
(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
—
000020417
HIGHMARK - BC/BS OF PA
PA
01
—
0453320000
AMERIHEALTH PERS CHOICE
PA
01
—
0658107000
AMERIHEALTH HMO
PA
01
—
7618325
AETNA
—
Enumeration date
01/03/2008
Last updated
05/10/2022
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