CONCOURSE SURGICAL SPORT SUPPLY, INC. (NPI# 1912910571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912910571 |
| Entity Type | Organization |
| Organization Name | CONCOURSE SURGICAL SPORT SUPPLY, INC. |
| Practice Address |
5049 Broadway New York NY 10034-1131 |
| Mailing Address |
8 Edgewood Dr Orangeburg NY 10962-1604 |
| Practice Telephone | 2125692635 |
| Practice Fax Number | 2125692639 |
| Mailing Telephone | 2125692635 |
| Mailing Fax Number | 2125692639 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-10-05 |
| Authorized Official Name | NIDIA PENA (MANAGER) |
| Authorized Official Telephone | 2125692635 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01785982 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CONCOURSE SURGICAL SPORT SUPPLY, INC. | 179 East 165th Street, Bronx, Ny 10456 |
| Street Address |
5049 BROADWAY |
| City | NEW YORK |
| State | NY |
| Zip Code | 10034-1131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134775174 | Dynamic Physical Therapy Rehab of Ny P.C. | Clinic/Center | 5049 Broadway, New York, NY 10034-1131 | 2019-08-15 |
| 1053884379 | Dynamic Physical Therapy and Sports Rehab | Clinic/Center | 5049 Broadway, New York, NY 10034-1131 | 2019-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649812512 | Vilma Lantigua | Physician Assistant | 90 Vermilyea Ave #139, New York, NY 10034 | 2019-10-11 |
| 1477037125 | Alexa Paige Ruffino | Physician Assistant | 5105 Broadway, New York, NY 10034 | 2018-09-19 |
| 1821514456 | Chinara M Tate | Dietitian, Registered | 520 W 218th Street, Apt 3a, New York, NY 10034 | 2017-08-15 |
| 1770006165 | Brittany Palmer | Speech-Language Pathologist | 10 Park Ter E Apt 4l, New York, NY 10034 | 2017-07-18 |
| 1457891947 | Easy Choice Agency | Home Health | 3863 10th Avenue, Ny, NY 10034 | 2017-03-02 |
| 1598114738 | Kent Haina Jr. | Nurse Anesthetist, Certified Registered | 133 Seaman Ave Apt 5a, New York, NY 10034 | 2016-06-08 |
| 1902274756 | Rosa Ma Caram | Early Intervention Provider Agency | 601 Kappock St., Apt. 4e, Bronx, NY 10034 | 2015-09-10 |
| 1104232040 | Michael Kwakye | General Practice | 5030 Broadway Ste 816, New York, NY 10034 | 2014-07-10 |
| 1619389624 | Jay Steven Reidler | Orthopaedic Surgery | Columbia Orthopedics, 5141 Broadway, 3 Field West, New York, NY 10034 | 2014-05-25 |
| 1467718247 | Sherman Medical Care, PC | Internal Medicine | 231 Sherman Ave, 1f, New York, NY 10034 | 2012-04-06 |
| Find all providers in zip 10034 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487271722 | Larry Kleinstein | Durable Medical Equipment & Medical Supplies | 437 W 44th St Apt 2re, New York, NY 10036-4443 | 2020-07-02 |
| 1366075939 | Vatrenko Gitlin Dental Offices PC | Durable Medical Equipment & Medical Supplies | 62 Rivington St, New York, NY 10002-2140 | 2020-02-21 |
| 1700351582 | Surgical Sock Shop II Inc | Durable Medical Equipment & Medical Supplies | 1476 1st Ave, New York, NY 10075-2202 | 2018-10-09 |
| 1528449378 | Cvs Albany LLC | Durable Medical Equipment & Medical Supplies | 757 3rd Ave, New York, NY 10017-2013 | 2015-06-17 |
| 1164676912 | Adaptive Design Association, Inc. | Durable Medical Equipment & Medical Supplies | 313 W 36th St, New York, NY 10018-6401 | 2008-11-06 |
| 1992964506 | Rina Chawla Otr | Durable Medical Equipment & Medical Supplies | 51 East 73 Street, Rm 2a, New York, NY 10021 | 2008-06-09 |
| 1285856385 | Support By Design Inc | Durable Medical Equipment & Medical Supplies | 60 Thomas St, Floor #1, New York, NY 10013 | 2007-05-02 |
| 1679622963 | Pillet Hand Prostheses, Ltd. | Durable Medical Equipment & Medical Supplies | 331 W 57th St, Pmb 109, New York, NY 10019-3101 | 2007-01-09 |
| 1336157650 | Ddg Medical Supplies | Durable Medical Equipment & Medical Supplies | 2465 Adam Clayton Powell Jr Blvd, New York, NY 10030-3518 | 2006-08-03 |
| 1306869136 | Eneslow Pedorthic Enterprises Inc | Durable Medical Equipment & Medical Supplies | 470 Park Avenue South, New York, NY 10016-6819 | 2006-07-25 |
| Find all providers in NEW YORK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.