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General NPI Number Information
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NPI Number | 1174825327
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Entity Type | Organization
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Legal Business Name | PECTUS SERVICES OF NY LLC
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Dates
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Enumeration Date | 11/21/2010
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Last Update Date | 11/21/2010
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Provider Practice Location Address
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Address Line | 774 MANOR RD SUITE 202
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City | STATEN ISLAND
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State | NY
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Zip | 10314-7038
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Country | US
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Telephone | 877-732-8876
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Fax | 973-488-7185
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Provider Business Mailing Address
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Address Line | 96 BELMOHR ST
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City | BELLEVILLE
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State | NJ
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Zip | 07109-2202
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Country | US
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Telephone | 877-732-8876
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Fax | 973-488-7185
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH A PORCELLO
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Credential |
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Telephone | 877-732-8876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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