| NPI | 1619234739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAZEL KUDERA Member 646-998-8068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BN1400X Durable Medical Equipment & Medical Supplies Nursing Facility Supplies |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2012-04-13 |