| NPI | 1073868394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD MANGANIELLO Member 203-483-8488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2012-07-24 |