1811580830 NPI number — G&I ORTHO SUPPLY INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811580830 NPI number — G&I ORTHO SUPPLY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
G&I ORTHO SUPPLY 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:
Provider Other Organization Name Type Code:
6
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:
1811580830
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
393 AVE X UNIT #2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
929-274-7766
Provider Business Mailing Address Fax Number:
929-406-1062

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
393 AVENUE X STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11223-6028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
929-274-7766
Provider Business Practice Location Address Fax Number:
929-406-1062
Provider Enumeration Date:
02/19/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAFAILOV
Authorized Official First Name:
ELCHIN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
212-920-0133

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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