Individual
HENRY JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
609 ROUTE 109 STE 2B4, WEST BABYLON, NY 11704-5072
(631) 470-3943
Mailing address
609 ROUTE 109 STE 2B4, WEST BABYLON, NY 11704-5072
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
810698404
NY
Other
Enumeration date
04/29/2016
Last updated
04/29/2016
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