Organization Active NPI

Mik Medical Supply Inc

  • Durable Medical Equipment & Medical Supplies
  • Brooklyn, NY
National Provider Identifier
1104735570
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MIK MEDICAL SUPPLY INC
Practice address
2615 Coney Island Ave Ste 2E
Brooklyn, NY 11223-5501
Phone
(917) 209-3091
NPI assigned
Sep 2, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Mikheil Khechuashvili
Title
Owner & Ceo
Phone
(917) 209-3091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2615 Coney Island Ave Ste 2E
Brooklyn, NY 11223-5501

Mailing address

2615 Coney Island Ave Ste 2E
Brooklyn, NY 11223-5501
Phone (917) 209-3091

NPI Registry JSON

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1104735570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 CONEY ISLAND AVE STE 2E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235501",
            "telephone_number": "917-209-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 CONEY ISLAND AVE STE 2E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235501",
            "telephone_number": "917-209-3091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIK MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "KHECHUASHVILI",
        "authorized_official_first_name": "MIKHEIL",
        "authorized_official_title_or_position": "OWNER & CEO",
        "authorized_official_telephone_number": "917-209-3091"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.