Provider Demographics
NPI:1275791360
Name:WILNO SURGICALS INC
Entity Type:Organization
Organization Name:WILNO SURGICALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED FITTER THERAPEUTIC SHOES
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:NORONHA
Authorized Official - Suffix:
Authorized Official - Credentials:CFTS
Authorized Official - Phone:718-292-5625
Mailing Address - Street 1:654 COURTLANDT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5002
Mailing Address - Country:US
Mailing Address - Phone:718-292-5625
Mailing Address - Fax:718-292-5644
Practice Address - Street 1:654 COURTLANDT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5002
Practice Address - Country:US
Practice Address - Phone:718-292-5625
Practice Address - Fax:718-292-5644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4984790001Medicare NSC