Statewide Medical and Surgical Supplies Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1118484 Issued in NY

Legal business name

STATEWIDE MEDICAL AND SURGICAL SUPPLIES INC.

Practice address

9602 Avenue L
Brooklyn, NY 11236-4813

Phone

(718) 257-8810

Fax

(718) 257-8806

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Miss Mercedes Desormeaux

Title

C.E.O

Phone

(718) 257-8810

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1104962547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9602 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364808",
            "telephone_number": "718-257-8810",
            "fax_number": "718-257-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9602 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364813",
            "telephone_number": "718-257-8810",
            "fax_number": "718-257-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE MEDICAL AND SURGICAL SUPPLIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "DESORMEAUX",
        "authorized_official_first_name": "MERCEDES",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "718-257-8810",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "1118484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02291367",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Staten Islan University Hospital
• Staten Island Eye Physicians PLLC
• Staten Island University Hospital
• Antonio Staten
• Skyler States
• Statewide Medical Care LLC
• Devorah Statfeld
• Itchie Statfeld, MD
• Maria Stathakos
• Henrietta Statham, LCSW

• 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 Dec 7, 2007; 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.