Provider Demographics
NPI:1063134310
Name:EJISQUARED, INC
Entity type:Organization
Organization Name:EJISQUARED, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:INFURNA
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:203-286-8945
Mailing Address - Street 1:28 KNIGHT ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-4719
Mailing Address - Country:US
Mailing Address - Phone:203-286-8945
Mailing Address - Fax:203-286-8945
Practice Address - Street 1:28 KNIGHT ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-4719
Practice Address - Country:US
Practice Address - Phone:203-286-8945
Practice Address - Fax:203-286-8945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies