Healthcare Provider Details

I. General information

NPI: 1831713502
Provider Name (Legal Business Name): ANOVA DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

997 ROSEDALE RD
VALLEY STREAM NY
11581-2702
US

IV. Provider business mailing address

997 ROSEDALE RD
VALLEY STREAM NY
11581-2702
US

V. Phone/Fax

Practice location:
  • Phone: 646-494-8866
  • Fax: 866-901-8002
Mailing address:
  • Phone: 646-494-8866
  • Fax: 866-901-8002

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 Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: ANCA SANDULESCU
Title or Position: OFFICE MANAGER
Credential:
Phone: 646-494-8866