| NPI | 1962432310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGEY LOSYEV Owner 718-645-4324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2014-09-12 |