| NPI | 1093731473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELLY BAKSHIYEV President/Owner 973-773-4566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 225000000X Orthotic Fitter |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2014-05-27 |