Provider Demographics
NPI:1063734002
Name:SURGICAL SOCK SHOP INC
Entity type:Organization
Organization Name:SURGICAL SOCK SHOP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEVORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-356-0049
Mailing Address - Street 1:1 JOSHUA CT
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3640
Mailing Address - Country:US
Mailing Address - Phone:845-425-2617
Mailing Address - Fax:845-425-5550
Practice Address - Street 1:6 ROMAN BLVD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3107
Practice Address - Country:US
Practice Address - Phone:845-356-0049
Practice Address - Fax:845-356-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies