Healthcare Provider Details

I. General information

NPI: 1700351582
Provider Name (Legal Business Name): SURGICAL SOCK SHOP II INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 10/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1476 1ST AVE
NEW YORK NY
10075-2202
US

IV. Provider business mailing address

5818 13TH AVE
BROOKLYN NY
11219-4906
US

V. Phone/Fax

Practice location:
  • Phone: 212-224-9550
  • Fax: 212-224-9560
Mailing address:
  • Phone: 877-330-5900
  • Fax: 718-871-9451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: BLIMA WEINGARTEN
Title or Position: PRESIDENT/ CERTIFIED FITTER
Credential:
Phone: 718-436-7880