| NPI | 1255506408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KEITH LEVY Owner 718-642-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NY N005753) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N005753) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-07-23 |