| NPI | 1114477692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PETERSON Officer 516-536-3577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2020-01-17 |