MEDICARE: JAZEE BRAS

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	:	1598108011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAZEE BRAS

Provider Business Mailing Address
First Line	:	937 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-2336
Country	:	US
Telephone Number	:	718-336-0783
Fax Number	:	718-336-7203

Provider Business Practice Location Address
First Line	:	937 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-2336
Country	:	US
Telephone Number	:	718-336-0783
Fax Number	:	718-336-7203

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SONYA RAISHEVICH
Credential	:	DMEMASTECTOMY FITTER
Telephone Number	:	718-336-0783

Provider Enumeration Date	:	04/15/2013
Last Update Date	:	04/15/2013

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Directions to “JAZEE BRAS ” Practice Location

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