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General NPI Number Information
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NPI Number | 1215663984
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Entity Type | Organization
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Legal Business Name | R&SUP2 INC
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 110 WALL ST
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City | NEW YORK
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State | NY
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Zip | 10005-3801
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Country | US
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Telephone | 516-660-6597
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Fax |
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Provider Business Mailing Address
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Address Line | 110 WALL ST
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City | NEW YORK
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State | NY
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Zip | 10005-3801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RITAYAN CHAKRABORTY
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Credential |
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Telephone | 516-660-6597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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