Provider Demographics
NPI: | 1740585470 |
---|---|
Name: | MEDICAL SUPPLIES OF NEW YORK INC |
Entity type: | Organization |
Organization Name: | MEDICAL SUPPLIES OF NEW YORK INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | JOSPEH |
Authorized Official - Last Name: | MAGGIACOMO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 516-326-8585 |
Mailing Address - Street 1: | PO BOX 20571 |
Mailing Address - Street 2: | |
Mailing Address - City: | FLORAL PARK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11002-0571 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 516-326-8585 |
Mailing Address - Fax: | 516-326-2538 |
Practice Address - Street 1: | 162 JERICHO TPKE |
Practice Address - Street 2: | |
Practice Address - City: | FLORAL PARK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11001-2006 |
Practice Address - Country: | US |
Practice Address - Phone: | 516-326-8585 |
Practice Address - Fax: | 516-326-2538 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-01-11 |
Last Update Date: | 2011-01-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 354972900 | 332B00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |