| NPI | 1639236276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALED H ELMASRY Board Certified Pedorthist 201-858-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MN 1963) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MN 1963) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2008-07-10 |