Provider Demographics
NPI:1659478006
Name:SVZ MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:SVZ MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMER
Authorized Official - Middle Name:
Authorized Official - Last Name:GEYKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-265-2903
Mailing Address - Street 1:2160 BATH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:718-265-2903
Mailing Address - Fax:
Practice Address - Street 1:2160 BATH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5008
Practice Address - Country:US
Practice Address - Phone:718-265-2903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0995025332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02381744Medicaid
NY02381744Medicaid