Provider Demographics
NPI:1265503379
Name:NICOBI HEALTH & SURGICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:NICOBI HEALTH & SURGICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:U
Authorized Official - Last Name:ORUCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-515-3300
Mailing Address - Street 1:3682B WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-5725
Mailing Address - Country:US
Mailing Address - Phone:718-515-3300
Mailing Address - Fax:718-515-3339
Practice Address - Street 1:3682B WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-5725
Practice Address - Country:US
Practice Address - Phone:718-515-3300
Practice Address - Fax:718-515-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1204744332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0258058Medicaid
5136430001Medicare NSC