Active NPI
Edwin Dhall
- Customized Equipment (DME)
- Brentwood, NY
National Provider Identifier
1760802490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- License
- C13-26498
- Practice address
- 712 Broadway
Brentwood, NY 11717-6922 - Phone
- (631) 456-8854
- Fax
- (631) 561-4245
- NPI assigned
- Apr 21, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | C13-26498 | NY | Primary |
Addresses
Primary practice location
712 Broadway
Brentwood, NY 11717-6922
Mailing address
712 Broadway
Brentwood, NY 11717-6922
Phone (631) 456-8854
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 352479821 | Other | NY | HMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C13-26498 | NY | MD | Customized Equipment (DME) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Top Choice Medical Supplies | Customized Equipment | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Customized Equipment (DME)
- Brentwood, NY
- NPI 1992125512
Customized Equipment
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398038400000",
"number": "1760802490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 BROADWAY",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117176922",
"telephone_number": "631-456-8854",
"fax_number": "631-561-4245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 BROADWAY",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117176922",
"telephone_number": "631-456-8854",
"fax_number": "631-561-4245"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DHALL",
"first_name": "EDWIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-21",
"last_updated": "2014-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": "NY",
"license": "C13-26498",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO",
"identifier": "352479821",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.