| NPI | 1437661493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY C VILLA-TINEO Officer 917-409-2876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2019-02-06 |