Provider Demographics
NPI:1174178750
Name:DURAMEDNJ LLC
Entity Type:Organization
Organization Name:DURAMEDNJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TEEPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-268-6072
Mailing Address - Street 1:3 WIEDEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-3412
Mailing Address - Country:US
Mailing Address - Phone:973-305-8830
Mailing Address - Fax:973-305-8818
Practice Address - Street 1:960 S BROADWAY STE 120
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-5028
Practice Address - Country:US
Practice Address - Phone:973-305-8830
Practice Address - Fax:973-305-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies