Organization
SP ORTHOTIC SURGICAL & MEDICAL SUPPLY,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRIGORIY SPIVAK (OWNER)
(718) 627-3305
Entity
Organization
Contact information
Practice address
2946 AVENUE S, BROOKLYN, NY 11229-3229
(718) 627-3305
(718) 627-3307
Mailing address
2946 AVE S, SP ORTHOTIC SURGICAL & MEDICAL SUPPLY, INC, BROOKLYN, NY 11229
(718) 627-3305
(718) 627-3307
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1189863
NY
Other
Enumeration date
08/30/2006
Last updated
08/05/2008
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