Provider Demographics
NPI:1225362593
Name:BRITO, HERNAN
Entity Type:Individual
Prefix:
First Name:HERNAN
Middle Name:
Last Name:BRITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 WALDO ST
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726-3119
Mailing Address - Country:US
Mailing Address - Phone:516-473-4004
Mailing Address - Fax:
Practice Address - Street 1:346 WALDO ST
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-3119
Practice Address - Country:US
Practice Address - Phone:516-473-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-19
Last Update Date:2009-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies