Provider Demographics
NPI:1245413426
Name:INOKON, PUCCINI (DME VENDOR)
Entity type:Individual
Prefix:
First Name:PUCCINI
Middle Name:
Last Name:INOKON
Suffix:
Gender:M
Credentials:DME VENDOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1162 SAINT JOHNS PL
Mailing Address - Street 2:1ST FLR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-2645
Mailing Address - Country:US
Mailing Address - Phone:646-244-8595
Mailing Address - Fax:
Practice Address - Street 1:1162 SAINT JOHNS PL
Practice Address - Street 2:1ST FLR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-2645
Practice Address - Country:US
Practice Address - Phone:646-244-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies