Organization
ACTIVE THERAPY SUPPLY, INC
Active
Other names
Active Home Health & Respiratory
Organization subpart
No
Provider details
NPI number
Authorized official
ROZA MINAZOVA (PRESIDENT)
(718) 544-2850
Entity
Organization
Contact information
Practice address
4050 NOSTRAND AVE STE 3M, BROOKLYN, NY 11235-2250
(718) 544-2850
(646) 416-6653
Mailing address
96-09 METROPOLITAN AVE., FOREST HILLS, NY 11375-6647
(718) 544-2850
(646) 416-6653
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01077054
—
NY
01
—
0119355
AETNA
NY
01
—
ANC1430
OXFORD
NY
Enumeration date
06/30/2005
Last updated
01/31/2024
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