Light Surgical Supply, Inc.
NPI #1053541359 in Forest Hills, New York
Provider Information
- NPI Number
- 1053541359
- Entity Type
- Organization
- Organization Name
- Light Surgical Supply, Inc.
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Jul 21, 2009
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 11610 QUEENS BLVD STE 101
- City
- Forest Hills
- State
- New York
- ZIP Code
- 11375-7055
- Phone
- (646) 930-7459
Authorized Official
- Name
- RAFAEL MAKSUMOV
- Title
- PRESIDENT
- Phone
- (646) 930-7459
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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