Organization
MID ISLAND MEDICAL SUPPLY LLC
Active
Other names
Mid Island Medical Supply Company, Medically Modern
Organization subpart
No
Provider details
NPI number
Authorized official
COREY DEUTSCH (CEO)
(845) 803-4368
Entity
Organization
Contact information
Practice address
161 E MAIN ST, MOUNT KISCO, NY 10549-2311
(347) 503-7148
(347) 503-7148
Mailing address
500 7TH AVE FL 8, NEW YORK, NY 10018-4502
(347) 503-7148
(347) 503-7148
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01577384
—
NY
01
—
100153504601
AMERICHOICE
GA
01
—
1535046
UNITED HEALTHCARE
GA
01
—
F394358
OXFORD
CT
Enumeration date
07/11/2006
Last updated
08/04/2026
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