Provider Demographics
NPI:1003990664
Name:MARO MEDICAL & SURGICAL SUPPLIES,INC
Entity Type:Organization
Organization Name:MARO MEDICAL & SURGICAL SUPPLIES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZINOVY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTROVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFEID PEDORTHIS
Authorized Official - Phone:908-289-9111
Mailing Address - Street 1:1156A E JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2311
Mailing Address - Country:US
Mailing Address - Phone:908-289-9111
Mailing Address - Fax:
Practice Address - Street 1:1156A E JERSEY ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2311
Practice Address - Country:US
Practice Address - Phone:908-289-9111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY443662332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02785615Medicaid
NY02785615Medicaid