| NPI | 1356547020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PASSET Owner 718-896-6369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X (Licence: NY N003006) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY 4254920001) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2008-01-31 |