Healthcare Provider Details

I. General information

NPI: 1316233117
Provider Name (Legal Business Name): AMERICAN ORTHOMEDICAL SUPPLIES CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 BAYVIEW AVE
INWOOD NY
11096-1701
US

IV. Provider business mailing address

455 BAYVIEW AVE
INWOOD NY
11096-1701
US

V. Phone/Fax

Practice location:
  • Phone: 212-627-6666
  • Fax: 516-239-4040
Mailing address:
  • Phone: 212-627-6666
  • Fax: 516-239-4040

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: MS. MARGARITA MORDUKHAYEVA
Title or Position: PRESIDENT
Credential:
Phone: 212-627-6666