MEDICARE: SLON MEDICAL INSTRUMENT LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171WH0202X	Home Modifications Contractor
2	3336C0003X	Community/Retail Pharmacy
3	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5803867	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1841273000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLON MEDICAL INSTRUMENT LLC

Provider Business Mailing Address
First Line	:	2550 W 13TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-5813
Country	:	US
Telephone Number	:	718-287-9553
Fax Number	:	718-287-9561

Provider Business Practice Location Address
First Line	:	2550 W 13TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-5813
Country	:	US
Telephone Number	:	718-287-9553
Fax Number	:	718-287-9561

Authorized Official
Title or Position	:	PRESIDENT
Name	:	INNA ITSKOVA
Credential	:
Telephone Number	:	718-287-9553

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	08/24/2022

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Directions to “SLON MEDICAL INSTRUMENT LLC ” Practice Location

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