| NPI | 1699052662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BASIL FARID Owner 718-948-6353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224L00000X |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2011-11-04 |