Provider Demographics
NPI:1750589172
Name:ADVANCED HEALTH & SURGICAL
Entity type:Organization
Organization Name:ADVANCED HEALTH & SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEALA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:718-921-1575
Mailing Address - Street 1:555 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6607
Mailing Address - Country:US
Mailing Address - Phone:718-921-1575
Mailing Address - Fax:718-462-3438
Practice Address - Street 1:555 E 17TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6607
Practice Address - Country:US
Practice Address - Phone:718-921-1575
Practice Address - Fax:718-462-3438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01091583Medicaid