Individual
STEPHEN AZETA IDAHOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
934 ROSE ST APT 301, READING, PA 19601-1465
(646) 734-9312
Mailing address
934 ROSE ST APT 301, READING, PA 19601-1465
(646) 734-9312
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/12/2013
Last updated
08/12/2013
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