| NPI | 1932385457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS TIBERIA Dpm 716-674-0375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY N003294-1) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |