Provider Demographics
NPI:1124321617
Name:BOSTON ORTHOPEDIC & RESPIRATORY EQUIPMENT LLC
Entity type:Organization
Organization Name:BOSTON ORTHOPEDIC & RESPIRATORY EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GILDSHTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-337-5133
Mailing Address - Street 1:175 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129
Mailing Address - Country:US
Mailing Address - Phone:617-337-5133
Mailing Address - Fax:617-337-5242
Practice Address - Street 1:175 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129
Practice Address - Country:US
Practice Address - Phone:617-337-5133
Practice Address - Fax:617-337-5242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies