Provider Demographics
NPI:1417496951
Name:LADDER MEDICAL SUPPLY
Entity Type:Organization
Organization Name:LADDER MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:IYASERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-288-7800
Mailing Address - Street 1:720 COURTLANDT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5084
Mailing Address - Country:US
Mailing Address - Phone:646-288-7800
Mailing Address - Fax:
Practice Address - Street 1:720 COURTLANDT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5084
Practice Address - Country:US
Practice Address - Phone:646-288-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies