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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
1060 KINGS HWY N STE 309, CHERRY HILL, NJ 08034
(610) 543-6800
(610) 543-8051
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
0453320000
AMERIHEALTH PERS CHOICE
NJ
01
0658107000
AMERIHEALTH
NJ
01
7618325
AETNA
NJ
Enumeration date
08/09/2006
Last updated
05/10/2022
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