NPI: 1730695164 · KEW GARDENS, NY 11415 · Durable Medical Equipment & Medical Supplies · NPI assigned 12/21/2017
| Authorized Official | FATTAKHOV, VYACHESLAV (PRESIDENT) |
| NPI Enumeration Date | 12/21/2017 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 25 | $554.05 |
| 2023 | 104 | $3K |