| NPI | 1467757591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESPINA FOUKARAKIS Provider Relations 732-415-2318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: NJ 04003305999) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2019-08-22 |