Individual
DMITRIY BAKHRAMOV SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 JERICHO TPKE STE B4, FLORAL PARK, NY 11001-2019
(917) 412-7370
Mailing address
110 JERICHO TPKE STE B4, FLORAL PARK, NY 11001-2019
(917) 412-7370
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2098686
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2098686-DCA
SUPPLY
NY
Enumeration date
12/14/2021
Last updated
12/14/2021
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