| NPI | 1922001155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TULIO RIVERA Owner 718-748-4806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: NY CP002645) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY CP002645) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: NJ 45PO00001600) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2009-03-24 |