Provider Demographics
NPI:1235275629
Name:SURGICAL SOCK SHOP II INC
Entity Type:Organization
Organization Name:SURGICAL SOCK SHOP II INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BLIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINGARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-436-7880
Mailing Address - Street 1:5818 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4906
Mailing Address - Country:US
Mailing Address - Phone:718-436-7880
Mailing Address - Fax:718-871-9451
Practice Address - Street 1:5818 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4906
Practice Address - Country:US
Practice Address - Phone:718-436-7880
Practice Address - Fax:718-871-9451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYANC002202OtherAMERICHOICE OF NEW YORK
NY1000043682OtherAFFINITY HEALTH PLAN
NYG71512OtherEMPIRE BLUE CROSS
NY000412358466OtherHEALTH PLUS
NY100198108501OtherUNITED NEW YORK MEDICAID
NYN42380OtherHEALTHNET
NYA805786OtherOXFORD HEALTH PLAN
NY01788976Medicaid
NYV00477099OtherUNITED HEALTHCARE
NY=========002OtherHEALTHFIRST
NY01788976Medicaid