Active Therapy Supply, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ACTIVE THERAPY SUPPLY, INC

Doing business as

Active Home Health & Respiratory

Practice address

4050 Nostrand Ave Ste 3M
Brooklyn, NY 11235-2250

Phone

(718) 544-2850

Fax

(646) 416-6653

NPI assigned

Jun 30, 2005

Last updated

Jan 31, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Roza Minazova

Title

President

Phone

(718) 544-2850

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Active Home Health & Respiratory Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1033116447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96-09 METROPOLITAN AVE.",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113756647",
            "telephone_number": "718-544-2850",
            "fax_number": "646-416-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 NOSTRAND AVE STE 3M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352250",
            "telephone_number": "718-544-2850",
            "fax_number": "646-416-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE THERAPY SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "MINAZOVA",
        "authorized_official_first_name": "ROZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-544-2850"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0119355",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01077054",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "ANC1430",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Home Health & Respiratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Active Home Health & Respiratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.