Provider Demographics
NPI:1013121847
Name:J & J HOME CARE & SURGICAL SUPPLY INC.
Entity Type:Organization
Organization Name:J & J HOME CARE & SURGICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESPIRATORY THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GERBINO
Authorized Official - Suffix:
Authorized Official - Credentials:RCP
Authorized Official - Phone:631-474-1777
Mailing Address - Street 1:135 CLIFF RD
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1032
Mailing Address - Country:US
Mailing Address - Phone:631-254-3934
Mailing Address - Fax:
Practice Address - Street 1:66 S 2ND ST STE H
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-1000
Practice Address - Country:US
Practice Address - Phone:631-254-3934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004017-1332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0576500001Medicare ID - Type UnspecifiedPRIMARY PROVIDER