Healthcare Provider Details

I. General information

NPI: 1306869136
Provider Name (Legal Business Name): ENESLOW PEDORTHIC ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 PARK AVENUE SOUTH
NEW YORK NY
10016-6819
US

IV. Provider business mailing address

470 PARK AVENUE SOUTH
NEW YORK NY
10016-6819
US

V. Phone/Fax

Practice location:
  • Phone: 212-477-2300
  • Fax: 212-477-2156
Mailing address:
  • Phone: 212-477-2300
  • Fax: 212-477-2156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1134201
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT S SCHWARTZ
Title or Position: PRESIDENT
Credential: CPED
Phone: 212-477-2300