| NPI | 1184163321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSLAN GLADKOVITZER Member 917-697-2026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2022-01-10 |