Provider Demographics
NPI:1609979624
Name:SHREE JEE SURGICAL SUPPLIES INC
Entity Type:Organization
Organization Name:SHREE JEE SURGICAL SUPPLIES INC
Other - Org Name:NEW YORK SURGICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BIREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-663-0300
Mailing Address - Street 1:127 S TERRACE AVE FL 2
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2407
Mailing Address - Country:US
Mailing Address - Phone:914-663-0300
Mailing Address - Fax:914-663-0772
Practice Address - Street 1:127 S TERRACE AVE FL 2
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2407
Practice Address - Country:US
Practice Address - Phone:914-663-0300
Practice Address - Fax:914-663-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023525332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02745664Medicaid
NY02745664Medicaid