Quality Custom Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1388246-DCA Issued in NY

Legal business name

QUALITY CUSTOM MEDICAL SUPPLY INC

Practice address

1727 Sheepshead Bay Rd
Brooklyn, NY 11235-3606

Phone

(718) 676-5092

Fax

(718) 676-5093

NPI assigned

Nov 22, 2017

Organization subpart

No

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

Authorized official

Name

Marina Bronivetskaya

Title

Manager

Phone

(718) 676-5092

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511308800000",
    "number": "1295249506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 SHEEPSHEAD BAY RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353606",
            "telephone_number": "718-676-5092",
            "fax_number": "718-676-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SHEEPSHEAD BAY RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353606",
            "telephone_number": "718-676-5092",
            "fax_number": "718-676-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY CUSTOM MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-22",
        "last_updated": "2017-11-22",
        "status": "A",
        "authorized_official_last_name": "BRONIVETSKAYA",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-676-5092"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "1388246-DCA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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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 Nov 22, 2017; 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.