Sidra Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SIDRA MEDICAL SUPPLY INC

Practice address

474 Meacham Ave
Elmont, NY 11003-3849

Phone

(718) 200-0723

Fax

(516) 706-6026

NPI assigned

Nov 3, 2022

Organization subpart

No

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

Authorized official

Name

Muhammad A Momen

Title

President

Phone

(718) 200-0723

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1255048609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 MEACHAM AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033849",
            "telephone_number": "718-200-0723",
            "fax_number": "516-706-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 MEACHAM AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110033849",
            "telephone_number": "718-200-0723",
            "fax_number": "516-706-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDRA MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "MOMEN",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-200-0723"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.