Healthcare Provider Details

I. General information

NPI: 1578491668
Provider Name (Legal Business Name): CITYMED MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981 BAY ST
STATEN ISLAND NY
10305-4903
US

IV. Provider business mailing address

981 BAY ST
STATEN ISLAND NY
10305-4903
US

V. Phone/Fax

Practice location:
  • Phone: 347-374-2560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: JACOB KOSOV
Title or Position: OWNER
Credential:
Phone: 347-374-2560