Organization
B & L MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAISA BRODSKY (PRESIDENT)
(201) 797-0304
Entity
Organization
Contact information
Practice address
23-21 BROADWAY, FAIR LAWN, NJ 07410
(201) 797-0304
(201) 797-0454
Mailing address
23-21 BROADWAY, FAIR LAWN, NJ 07410
(201) 797-0304
(201) 797-0304
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000205600
AMERICHOICE
—
01
—
2489251
AETNA
—
05
—
8218102
—
NJ
01
—
94289
AMERIGROUP
NJ
Enumeration date
06/07/2006
Last updated
05/01/2008
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