Healthcare Provider Details

I. General information

NPI: 1306130984
Provider Name (Legal Business Name): EZ BREATHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2011
Last Update Date: 11/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E 117TH ST STORE 1
NEW YORK NY
10035-4826
US

IV. Provider business mailing address

235 E 117TH ST STORE 1
NEW YORK NY
10035-4826
US

V. Phone/Fax

Practice location:
  • Phone: 917-338-9551
  • Fax: 888-520-2353
Mailing address:
  • Phone: 917-338-9551
  • Fax: 888-520-2353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number001907-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number001907-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number001907-1
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number001907-1
License Number StateNY

VIII. Authorized Official

Name: MISS PAULA HARGETT
Title or Position: OWNER
Credential: CRTT
Phone: 718-909-1789