Provider Demographics
NPI:1023232501
Name:ALBA INTERNATIONAL TRADING CORP.
Entity type:Organization
Organization Name:ALBA INTERNATIONAL TRADING CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZAUR
Authorized Official - Middle Name:
Authorized Official - Last Name:YUSUFOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-252-4120
Mailing Address - Street 1:4809 AVENUE N
Mailing Address - Street 2:SUITE 324
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3711
Mailing Address - Country:US
Mailing Address - Phone:718-252-4120
Mailing Address - Fax:718-252-3832
Practice Address - Street 1:2308 KNAPP ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5924
Practice Address - Country:US
Practice Address - Phone:718-252-4120
Practice Address - Fax:718-252-3832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0957121332BX2000X, 335E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03172061Medicaid
NY0701360001Medicare NSC