| NPI | 1346522448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIYEL ADZHIASHVILI Owner 917-304-6657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: NY 33) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2011-09-14 |