Healthcare Provider Details

I. General information

NPI: 1609700418
Provider Name (Legal Business Name): GLORIA'S SUPPLIES BRONX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 PIERCE AVE APT 2
BRONX NY
10462-3165
US

IV. Provider business mailing address

1003 PIERCE AVE # 2
BRONX NY
10462-3165
US

V. Phone/Fax

Practice location:
  • Phone: 718-473-6415
  • Fax:
Mailing address:
  • Phone: 718-473-6415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. GLORIA STOYANOVA
Title or Position: OWNER
Credential:
Phone: 718-473-6415