Provider Demographics
NPI:1821455726
Name:INNOVATIVE SOLUTIONS
Entity Type:Organization
Organization Name:INNOVATIVE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAUSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-490-3489
Mailing Address - Street 1:1107 WASHINGTON ST
Mailing Address - Street 2:UNIT 2
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5384
Mailing Address - Country:US
Mailing Address - Phone:914-490-3489
Mailing Address - Fax:888-975-4377
Practice Address - Street 1:1107 WASHINGTON ST
Practice Address - Street 2:UNIT 2
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5384
Practice Address - Country:US
Practice Address - Phone:914-490-3489
Practice Address - Fax:888-975-4377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies