| NPI | 1568965218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARITA DEGTYAREVA President 718-743-0299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NY 050331) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 050331) |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-08 |