| NPI | 1962711812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRIGORIY YUSUPOV Owner 718-413-0413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NY 1371300) |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2010-09-27 |