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Suppliers Durable Medical Equipment & Medical Supplies

Provider NPI: 1972501294

Organization Information:
Organization is not Subpart
Authorized Official:  ANGELO  DEFAZIO  PRESIDENT CEO  860-570-0543

Practice Location:
Tel: 860-522-9289  Fax: 860-231-7007

Business Mailing Address:
Tel: 860-570-0543  Fax: 860-570-0529

NPI Information:
NPI: 1972501294
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Durable Medical Equipment & Medical Supplies
Durable Medical Equipment & Medical Supplies
Durable Medical Equipment & Medical Supplies
Durable Medical Equipment & Medical Supplies
Prosthetic/Orthotic Supplier

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 333600000X





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