| NPI | 1881251544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN DAMARIS BOTERO-NEBEL Owner 718-984-1729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-09-20 |