Organization
79 MASADA III INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX STEFMAN (PRESIDENT)
(917) 365-7535
Entity
Organization
Contact information
Practice address
1319 E 17TH ST, BROOKLYN, NY 11230-6008
(917) 365-7535
(718) 336-0585
Mailing address
1319 E 17TH ST, BROOKLYN, NY 11230-6008
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
B01710
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03792894
—
NY
Enumeration date
04/25/2014
Last updated
04/25/2014
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