Organization
MODIFICATIONS & EQUIPMENT FOR INDEPENDENT LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD JOHN LEMNER (OWNER)
(518) 279-0888
Entity
Organization
Contact information
Practice address
339 SMITH HILL RD, TROY, NY 12180-8985
(518) 279-0888
(518) 279-1560
Mailing address
339 SMITH HILL RD, TROY, NY 12180-8985
(518) 279-0888
(518) 279-1560
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000402661000
HMO DME PROVIDER
NY
05
—
01807845
—
NY
01
—
01884220
TBI
NY
05
—
01884220
—
NY
01
—
10070305
HMO DME PROVIDER
NY
Enumeration date
04/20/2007
Last updated
07/16/2008
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