MEDICARE: NUYAN MED EXPRESS CO, INC

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	2049012 DCA	NY

General Provider Information

NPI Number	:	1750814778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUYAN MED EXPRESS CO, INC

Provider Business Mailing Address
First Line	:	2920 AVENUE R
Second Line	:	SUITE 1000
City	:	BROOKLYN
State	:	NY
Zip	:	11229-2524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 AVENUE R
Second Line	:	SUITE 1000
City	:	BROOKLYN
State	:	NY
Zip	:	11229-2524
Country	:	US
Telephone Number	:	718-376-2920
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YAKOV SOKOLOVSKY
Credential	:
Telephone Number	:	718-376-2920

Provider Enumeration Date	:	04/06/2017
Last Update Date	:	04/06/2017

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