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General NPI Number Information
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NPI Number | 1740522820
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Entity Type | Organization
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Legal Business Name | SUPERIOR SPINE LLC
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 131 BARRY ST
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City | STATEN ISLAND
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State | NY
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Zip | 10309-1601
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Country | US
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Telephone | 646-812-0606
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Fax | 800-521-7886
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Provider Business Mailing Address
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Address Line | 4062 AMBOY RD
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City | STATEN ISLAND
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State | NY
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Zip | 10308-2409
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Country | US
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Telephone | 646-812-0606
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Fax | 800-521-7886
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Authorized Official
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Title or Position | OWNER
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Name | ROSEMARY DIPAOLA
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Credential |
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Telephone | 646-812-0606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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