| NPI | 1629466685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RAFAILOV Owner 718-645-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2024-01-09 |