| NPI | 1710485875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTEVAN RODRIGUEZ Administrator 631-792-0427 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2022-03-15 |