Healthcare Provider Details

I. General information

NPI: 1497617088
Provider Name (Legal Business Name): ASTRA MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 US HIGHWAY 22 E STE 100-22
UNION NJ
07083-3414
US

IV. Provider business mailing address

1620 US HIGHWAY 22 E STE 100-22
UNION NJ
07083-3414
US

V. Phone/Fax

Practice location:
  • Phone: 856-612-7872
  • Fax: 856-792-7872
Mailing address:
  • Phone: 856-612-7872
  • Fax: 856-792-7872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: NUCHEM DOV JACOBOWITZ
Title or Position: PRESIDENT
Credential:
Phone: 718-483-4467