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NPI 1053800037

NPI 1053800037 : MOUNT SINAI MEDICAL SUPPLY 2 INC : JAMAICA, NY

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General NPI Number Information
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    NPI Number           |    1053800037
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    Entity Type          |    Organization 
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    Legal Business Name  |    MOUNT SINAI MEDICAL SUPPLY 2 INC 
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Dates
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    Enumeration Date     |    05/06/2018
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    Last Update Date     |    05/06/2018
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Provider Practice Location Address
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    Address Line         |    8010 162ND ST 
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    City                 |    JAMAICA
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    State                |    NY
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    Zip                  |    11432-1113
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    Country              |    US
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    Telephone            |    347-577-9988
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8010 162ND ST 
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    City                 |    JAMAICA
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    State                |    NY
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    Zip                  |    11432-1113
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ALBERT  KANDINOV 
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    Credential           |    
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    Telephone            |    347-577-9988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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