| NPI | 1689740417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL S PARK Podiatrist 607-734-4582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY N003995-1) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY N003322-1) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY N005567-1) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY N006213) | |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2013-04-24 |