Provider Demographics
NPI:1184655326
Name:ASTA SURGICAL CHEMIST
Entity type:Organization
Organization Name:ASTA SURGICAL CHEMIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-441-7711
Mailing Address - Street 1:10813 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2243
Mailing Address - Country:US
Mailing Address - Phone:718-441-7711
Mailing Address - Fax:718-441-2018
Practice Address - Street 1:10813 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2243
Practice Address - Country:US
Practice Address - Phone:718-441-7711
Practice Address - Fax:718-441-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00884386Medicaid
NY0273800001Medicare ID - Type Unspecified