| NPI | 1366551376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRIGORIY SPIVAK Owner 718-627-3305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY 1189863) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-08-05 |