| NPI | 1356530190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE A PECKAGE President 518-438-3544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N002732) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-12-10 |