OrganizationActive
Concourse Surgical Sport Supply, Inc.
NPI 1912910571 · Customized Equipment (DME) · New York, NY
Provider details
- NPI number
- 1912910571
- Entity type
- Organization
- Primary specialty
- Customized Equipment (DME)Suppliers
- Organization subpart
- No
- Authorized official
- Nidia Pena, Manager(212) 569-2635
Specialties & taxonomies
Suppliers
Practice location
5049 Broadway
New York, NY 10034-1131
Phone: (212) 569-2635
Fax: (212) 569-2639
Approximate (ZIP-level) locationGet directions
Mailing address
8 Edgewood Dr
Orangeburg, NY 10962-1604
Registry dates
- Enumerated
- 2006-08-14
- Last updated
- 2020-10-05
- Certified
- 2020-10-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.