Organization
SUPREME GENERATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BORIS GULKAROV (PRESIDENT)
(718) 841-7100
Entity
Organization
Contact information
Practice address
14766 77TH AVE, FLUSHING, NY 11367-3124
(718) 841-7100
(718) 841-7517
Mailing address
147-66 77TH AVE, FLUSHING, NY 11367
(718) 841-7100
(718) 841-7517
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NY
Other
Enumeration date
04/24/2017
Last updated
04/24/2017
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