MEDICARE: THERAPEUTIC MOBILIZATION DEVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1295019719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC MOBILIZATION DEVICES LLC

Provider Business Mailing Address
First Line	:	12 BOND ST
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-2005
Country	:	US
Telephone Number	:	212-588-0993
Fax Number	:	516-466-4296

Provider Business Practice Location Address
First Line	:	12 BOND ST
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-2005
Country	:	US
Telephone Number	:	212-588-0993
Fax Number	:	516-466-4296

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HOWARD A. ISRAEL
Credential	:	DDS
Telephone Number	:	212-588-0993

Provider Enumeration Date	:	10/03/2011
Last Update Date	:	10/03/2011

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