Provider Demographics
NPI:1265457238
Name:TASK SUPPLY
Entity Type:Organization
Organization Name:TASK SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:TSIRULNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-735-3400
Mailing Address - Street 1:1546 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2514
Mailing Address - Country:US
Mailing Address - Phone:718-735-3400
Mailing Address - Fax:718-735-3444
Practice Address - Street 1:1546 FULTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-2514
Practice Address - Country:US
Practice Address - Phone:718-735-3400
Practice Address - Fax:718-735-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01332BX2000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0614070002Medicare NSC