MEDICARE: DENDRO TECHNOLOGIES INC

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	:	1962207324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENDRO TECHNOLOGIES INC

Provider Business Mailing Address
First Line	:	459 COLUMBUS AVE # 4054
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-5129
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	459 COLUMBUS AVE # 4054
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-5129
Country	:	US
Telephone Number	:	917-434-0203
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ADI WALLACH
Credential	:
Telephone Number	:	917-434-0203

Provider Enumeration Date	:	02/18/2025
Last Update Date	:	04/02/2025

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