Provider Demographics
NPI:1851579775
Name:ENESLOW LITTLE NECK LLC
Entity Type:Organization
Organization Name:ENESLOW LITTLE NECK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:212-477-2300
Mailing Address - Street 1:470 PARK AVE S
Mailing Address - Street 2:FRONT 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6819
Mailing Address - Country:US
Mailing Address - Phone:212-477-2300
Mailing Address - Fax:212-353-2876
Practice Address - Street 1:25461 HORACE HARDING EXPY
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1816
Practice Address - Country:US
Practice Address - Phone:718-357-5800
Practice Address - Fax:718-357-0531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6389580001Medicare NSC