Organization
CUSTOM EQUIPMENT NY INC
Active
Organization
CUSTOM EQUIPMENT NY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARITA LISENENKOV (OWNER)
(347) 871-0570
Entity
Organization
Contact information
Practice address
83 4TH AVE, BROOKLYN, NY 11217-2703
(347) 871-0570
Mailing address
110 HORATIO ST APT 114, NEW YORK, NY 10014-1572
(347) 871-0570
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255761318
NPPES
NY
Enumeration date
02/05/2019
Last updated
02/05/2019
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