Provider Demographics
NPI:1578224416
Name:SUNNYSIDE MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:SUNNYSIDE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-238-1439
Mailing Address - Street 1:777 WASHINGTON RD STE 5
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1074
Mailing Address - Country:US
Mailing Address - Phone:732-238-1439
Mailing Address - Fax:
Practice Address - Street 1:777 WASHINGTON RD STE 5
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1074
Practice Address - Country:US
Practice Address - Phone:732-238-1439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-03
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies