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General NPI Number Information
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NPI Number | 1306255880
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Entity Type | Organization
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Legal Business Name | HEALTHY CHOICE SERVICES INC
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 10525 65TH AVE APT 4B
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City | FOREST HILLS
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State | NY
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Zip | 11375-1802
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Country | US
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Telephone | 347-551-1665
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Fax |
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Provider Business Mailing Address
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Address Line | 10525 65TH AVE APT 4B
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City | FOREST HILLS
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State | NY
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Zip | 11375-1802
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Country | US
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Telephone | 347-551-1665
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | MRS. DIANA AULOV
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Credential | MS OTR/L
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Telephone | 347-551-1665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | 0173781
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License Number State | NY
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