1538205323 NPI number — MOUNT SINAI SURGICAL SUPPLIES INC.

Table of content: (NPI 1538205323)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538205323 NPI number — MOUNT SINAI SURGICAL SUPPLIES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUNT SINAI SURGICAL SUPPLIES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SAM SURGICAL SUPPLY INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538205323
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8008 BAXTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELMHURST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11373-1313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-507-4444
Provider Business Mailing Address Fax Number:
718-457-3212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8008 BAXTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELMHURST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11373-1313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-507-4444
Provider Business Practice Location Address Fax Number:
718-457-3212
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KARIM
Authorized Official First Name:
NAIYER
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-507-4444

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 99596601 . This is a "NEIGHBORHOOD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01774574 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10200308 . This is a "AMERI GROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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