Provider Demographics
NPI:1487729620
Name:A-1 SURGICAL AND MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:A-1 SURGICAL AND MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:P
Authorized Official - Last Name:CORSENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:BD CO CERTIFIED ORTH
Authorized Official - Phone:516-741-1087
Mailing Address - Street 1:30 EAST JEFFERSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3123
Mailing Address - Country:US
Mailing Address - Phone:516-741-1087
Mailing Address - Fax:
Practice Address - Street 1:30 EAST JEFFERSON AVENUE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3123
Practice Address - Country:US
Practice Address - Phone:516-741-1087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ00236OtherMDNY
G71561OtherEMPIRE BCBS
G71572OtherEMPIRE BCBS
040401000676OtherFIDELIS CARE
G71571OtherEMPIRE BCBS
NY00923693Medicaid
G71521OtherEMPIRE BCBS
G71562OtherEMPIRE BCBS
NY1000017730OtherAFFINITY HEALTH PLAN
NY544385OtherAETNA
NY4881406OtherAETNA
G71573OtherEMPIRE BCBS
G71521OtherEMPIRE BCBS