Organization
POLY-TECH SLEEP SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRABHAKARA R TUMPATI M.D. (OWNER/PRESIDENT)
(267) 864-6101
Entity
Organization
Contact information
Practice address
1718 WELSH RD, SECOND FLOOR, SUITE C, PHILADELPHIA, PA 19115-4213
(215) 676-2334
(215) 676-2366
Mailing address
1718 WELSH RD, SECOND FLOOR, SUITE C, PHILADELPHIA, PA 19115-4213
(215) 676-2334
(215) 676-2366
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
MD432380
PA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD432380
PA
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
YM005236L
PA
Other
Enumeration date
07/21/2009
Last updated
01/03/2012
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