Healthcare Provider Details

I. General information

NPI: 1669771127
Provider Name (Legal Business Name): COMPRESSION MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 WOODLAND AVE #2
YONKERS NY
10703
US

IV. Provider business mailing address

270 WOODLAND AVE #2
YONKERS NY
10703
US

V. Phone/Fax

Practice location:
  • Phone: 914-751-1826
  • Fax: 718-208-4130
Mailing address:
  • Phone: 914-751-1826
  • Fax: 718-208-4130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1383805
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number1383805
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number1383805
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number1383805
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number1383805
License Number StateNY

VIII. Authorized Official

Name: ANTHONY RICHARDSON
Title or Position: PARTNER
Credential:
Phone: 914-751-7250