Provider Demographics
NPI:1396553749
Name:REZA SUPPLY INC
Entity type:Organization
Organization Name:REZA SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAKHMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:USTAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-527-2908
Mailing Address - Street 1:8008 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4131
Mailing Address - Country:US
Mailing Address - Phone:347-527-2908
Mailing Address - Fax:347-612-4067
Practice Address - Street 1:8008 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4131
Practice Address - Country:US
Practice Address - Phone:347-527-2908
Practice Address - Fax:347-612-4067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies