Provider Demographics
NPI:1154850261
Name:D. A. SURGICAL SUPPLY, INC
Entity Type:Organization
Organization Name:D. A. SURGICAL SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSTOMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-743-6600
Mailing Address - Street 1:PO BOX 245146
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-5146
Mailing Address - Country:US
Mailing Address - Phone:718-661-3366
Mailing Address - Fax:718-661-4666
Practice Address - Street 1:14256 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-6042
Practice Address - Country:US
Practice Address - Phone:718-661-3366
Practice Address - Fax:718-661-4666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies