Healthcare Provider Details

I. General information

NPI: 1043238868
Provider Name (Legal Business Name): ROCKLYN SURGICAL SUPPLY CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

492 MERRICK RD
ROCKVILLE CTR NY
11570
US

IV. Provider business mailing address

492 MERRICK RD
ROCKVILLE CTR NY
11570
US

V. Phone/Fax

Practice location:
  • Phone: 516-594-7800
  • Fax: 516-594-7808
Mailing address:
  • Phone: 516-594-7800
  • Fax: 516-594-7808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MANDEL FOGEL
Title or Position: PRESIDENT
Credential: REG PHARMACIST
Phone: 516-594-7800