Provider Demographics
NPI:1740599497
Name:BIG APPLE ORTHO MED SUPPLY INC
Entity Type:Organization
Organization Name:BIG APPLE ORTHO MED SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANASTASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSTENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-810-8700
Mailing Address - Street 1:1560 MAYFLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5400
Mailing Address - Country:US
Mailing Address - Phone:347-810-8700
Mailing Address - Fax:347-810-8699
Practice Address - Street 1:1560 MAYFLOWER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5400
Practice Address - Country:US
Practice Address - Phone:347-810-8700
Practice Address - Fax:347-810-8699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1368128332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies