| NPI | 1720523376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRACHA L OLLECH Owner 845-352-7545 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: NY 041911) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2019-04-01 |