Organization
BENEFICIAL MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NELLY BAKSHIYEV (PRESIDENT/OWNER)
(973) 773-4566
Entity
Organization
Contact information
Practice address
361 PASSAIC STR, PASSAIC, NJ 07055-5818
(973) 773-4566
(973) 473-8868
Mailing address
361 PASSAIC STR, PASSAIC, NJ 07055-5818
(973) 773-4566
(973) 473-8868
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0382868
—
NJ
Enumeration date
07/15/2006
Last updated
05/27/2014
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