MEDICARE: PUCCINI INOKON DME VENDOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1245413426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PUCCINI INOKON DME VENDOR

Provider Business Mailing Address
First Line	:	1162 SAINT JOHNS PL
Second Line	:	1ST FLR
City	:	BROOKLYN
State	:	NY
Zip	:	11213-2645
Country	:	US
Telephone Number	:	646-244-8595
Fax Number	:

Provider Business Practice Location Address
First Line	:	1162 SAINT JOHNS PL
Second Line	:	1ST FLR
City	:	BROOKLYN
State	:	NY
Zip	:	11213-2645
Country	:	US
Telephone Number	:	646-244-8595
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2007
Last Update Date	:	12/11/2007

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Directions to “ PUCCINI INOKON DME VENDOR” Practice Location

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