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NPI Code Detail

MEDICARE: AIIE CORP

MEDICARE: AIIE CORP
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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy035838NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12175280OTHERPK

General Provider Information

NPI Number : 1730695164
Entity Type Code : Organization
Provider Name (Legal Business Name) : AIIE CORP
Provider Business Mailing Address
First Line : 120-84 QUEENS BLVD
Second Line :
City : KEW GARDENS
State : NY
Zip : 11415
Country : US
Telephone Number : 718-872-9772
Fax Number : 646-813-1803
Provider Business Practice Location Address
First Line : 12084 QUEENS BLVD
Second Line :
City : KEW GARDENS
State : NY
Zip : 11415-1204
Country : US
Telephone Number : 718-872-9772
Fax Number : 646-813-1803
Authorized Official
Title or Position : PRESIDENT
Name : VYACHESLAV FATTAKHOV
Credential :
Telephone Number : 718-872-9772
Provider Enumeration Date : 12/21/2017
Last Update Date : 10/23/2020

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Directions to “AIIE CORP ” Practice Location

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