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 |