Provider Demographics
NPI:1568885622
Name:EMPIRE STATE MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:EMPIRE STATE MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:INNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYUBRONETSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:917-755-1386
Mailing Address - Street 1:210 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CHITTENANGO
Mailing Address - State:NY
Mailing Address - Zip Code:13037-1790
Mailing Address - Country:US
Mailing Address - Phone:917-755-1386
Mailing Address - Fax:718-375-2735
Practice Address - Street 1:210 GENESEE ST
Practice Address - Street 2:
Practice Address - City:CHITTENANGO
Practice Address - State:NY
Practice Address - Zip Code:13037-1790
Practice Address - Country:US
Practice Address - Phone:917-755-1386
Practice Address - Fax:718-375-2735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies