| Organization Name: | PRIME HEALTHCARE (SLEEP LAB) |
| NPI Number: | 1184832354 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN BRUNO (CEO) |
| Mailing Address: | 30 Jordan Ln Wethersfield |
| State: | CT US |
| Postal Code: | 061091278 |
| Phone Number: | 8602630253 |
| Fax Number: | 8602630262 |
| NPI Enumeration Date: | 05/19/2007 |
| NPI Last Update Date: | 05/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Sleep Disorder Diagnostic |
| Taxonomy Definition: | |